May 19, 2018
[05:01] About Joanna Penn and Dr. Euan Lawson
[11:30] What Joanna Had to Deal With When Writing
[12:45] The Difference Between Type 1 and 2 RSI
[18:15] The 20-20-20 Rule Regarding Screens/Monitors
[23:45] How to Actively Sit
[27:30] Ambi-mouse-trous, Not Ambidextrous
[29:15] Euan’s Preferred External Keyboard
[35:15] The Alexander Technique and How it Works
[40:00] Using the FODMAP Diet
[43:40] Are Psychotropics as Effective as They Are For Writers?
[52:00] Ben’s Strategy for Walking Thousands of Steps
[55:45] How Joanna and Euan Co-wrote and What Software They Use
[1:00:31] End of Podcast
Ben: Hey, welcome to today’s show. If you have carpal tunnel, you’re probably gonna wanna listen in. If you have wrist issues or neck issues or back issues, if you type on a freakin’ laptop, this podcast is for you. It helped me out tremendously, it’s with a doctor who co-wrote a book called “The Healthy Writer” with another gal whose podcast I listen to, Joanna Penn. She puts out an amazing writer’s podcast. Many of you may not know, I wrote a 500-page work of fiction over the past two years and I really followed Joanna quite a bit to give me advice as I was writing that book called “The Forest”. You can check that out over at bengreenfieldfitness.com/theforest. Go immerse yourself in a magical fantasy world that I created with two young protagonists inspired by my twin boys.
But before we jump in, speaking of a magical fantasy world, have you been to the Onnit website? Onnit, you got over there, it’s bengreenfieldfitness.com/onnit. May I recommend to you as your [0:00:58] ______ of Onnit, the emulsified MCT oil that is cinnamon swirl flavored. It is an MCT oil but emulsified scientifically, coz I’m a real MCT scientist, it means it doesn’t have to be blended. You just pour it in and you stir and go, there’s no clean-up, there’s no blenders, nothing. Emulsification means they combine air and water to allow the fats to disperse evenly so there’s no more MCT oil slicks on the top of your coffee or whatever else you blend this stuff into. And the cinnamon flavor, holy moly, it’s amazing. Onnit has functional foods, nut butters, they’ve got fitness, they’ve got apparel, they’ve got everything. When I say they’ve got fitness, what I mean by that is they have fitness gear: kettlebells, battle ropes, suspension rings. Half my home gym is Onnit stuff, that’s how cool these folks are, I love ‘em. So cinnamon swirl though is one of their flavors of their emulsified MCT oil. If anything, if you have a last wish in life, get the emulsified cinnamon… or maybe go donate money to the poor, and then get emulsified cinnamon swirl MCT oil.
By the way, it goes quite nicely in the Kion Coffee, which this podcast is also brought to you by. The wonderful Kion Coffee, rich in antioxidants, we tested it against every other coffee in America… just about all of them. We tested against Starbucks and Folger’s and Harvest Farms and… gosh, what else? Blue Bottle, Pete’s, Trader Joe’s, all of them. We tested in some cases at 10 times the amount of antioxidants. More than 60% of those coffees we tested came back with mold and other contaminants in them, ours did not; it was 100% mold and mycotoxin-free. We tested in three different laboratories around the world. We tested in Rio, we tested in Lisbon, there’s one other place that we tested and I forget where that lab is… oh Chicago, sorry Chicago. So we test 49 of the world’s top coffee brands then we test ours, and ours blows everything out of the water. And may I say, I may be a little bit jaded, but it tastes freakin’ just out of sight. It has mind-blowing aroma and mind-blowing flavor. We’ve got free coffee brewing guides, we have coffee, we have a monthly subscription that saves you a boatload of money on Kion Coffee, all of that is over at the Kion website. Just go to getkion.com/coffee, so check it out, getkion.com/coffee and now let’s talk about writing which pairs quite well with coffee.
In this episode of the Ben Greenfield Fitness Show:
“Laptops are just evil, really, they just batter you. Everything is in the wrong position, your wrists are all cocked in the wrong direction.” “There’s a little bit of a stigma around it, I think, as well. People sometimes feel that it hasn’t been taken seriously by the medical profession, and sometimes the problem with these conditions which are very nebulous and there’s not just one thing that presents in all sorts of different ways, it’s that they’re just lumped together.”
Ben: And I’ll tell you, just like two 1-hour calls, I had 16,000 steps yesterday.
Hey folks, it’s Ben Greenfield, and a while back I had an author named Joanna Penn on my podcast. And Joanna had developed these chronic repetitive motion injuries in her wrist and her elbow, and we took a deep dive into ergonomic keyboards and ergonomic computer mice and how they weren’t working for her. What she wound up doing instead, how she wrote a book while simultaneously training for an ultra-marathon and did so using different tools and microphones and software that allowed her to work quite well using dictation and training her computer to recognize her voice and her accent. And we even delved into how to enhance productivity, ambient noise, focus apps, and a whole bunch of really practical takeaways especially if you spend your time on a computer. And I’m gonna go ahead and put that previous podcast and all the show notes for it, if you just go to bengreenfieldfitness.com/healthywriter because Joanna has just finished penning a brand new book that she wrote along with a British medical doctor named Dr. Euan Lawson. And Dr. Lawson, her co-author for this book helped her delve into addressing things like her back pain and her migraines and her repetitive strain injuries. And they send me this book and I read it and it’s just chockful of practical, actionable information for anybody who writes, who types, who like me might be hunched over a laptop. Who isn’t these days, it seems? Unless you’re a freakin’ farmer, I guess. So Dr. Lawson and I are going to dive into some of the new topics from this brand new book. Joanna may join us later on, she was having a few Skype calling issues but we may bring her in as well. But in the meantime, Dr. Lawson, thanks so much for coming on the show, man.
Euan: Hi Ben, good to be here. Call me Euan, you make me feel about 100, calling me Dr. Lawson.
Ben: Well the reason I was calling you Dr. Lawson was your name is spelled E-U-A-N and I wasn’t quite sure how to pronounce Euan, I didn’t wanna stick my foot in my mouth during the whole podcast so I was gonna just sound all respectful, but…
Euan: Yeah, no. You said it at the start, you nailed it, it’s Euan, yeah.
Ben: Okay, got it. Not “E-yon” or “Yu-wane”.
Euan: Yeah, you just pretend there’s a “W” there and it’s exactly the same, Euan.
Ben: Nailed it. I’d do great in England if I lived over there. Hey so before we go all doom and gloom [laughs], talk about a lot of the issues that can arise with writing, writing can be good for your health and I never actually kinda thought that much about the benefits, from a health standpoint, of writing. But you guys delve into them in the book. Why would writing actually be good for you?
Euan: I mean I think we were keen to make sure that there was a risk that it did come across as very doom and gloom if we just plunged into all the horrors of sitting in front of a screen and not moving all day. I guess one of the major things I think that is great for you is if it’s your passion and your thing in life, writing, then actually following your passion’s very hard to either dispute as being the best possible thing you can be doing. But then there’s some medical evidence around writing as well, and particularly things like gratitude journals which have got really astonishingly good evidence for it. Minimal amounts of gratitude and writing it down in a journal and reflecting really helping your psychological health and going on to helping things like your sleep. And if you help your sleep, that’s then a superpower in terms of your overall health. If you get your sleep right, you live longer, you’re less likely to get cancer, and I think you can trace all that back to writing.
Ben: Interesting. And have they actually done studies on writers and found that they have less anxiety or less cortisol or anything like that or is this more one of those deals where we know one of the people who start off the day with free writing, or some people will do the two-page exercise each morning, that they’re just generally happier and healthier from an observational standpoint?
Euan: Yeah, I think the studies are kind of extrapolating a little. There’s no cohort of writers that have looked at and said “yeah, they’ve kind of been able to follow them long enough to see that they’re definitely healthier.” But the smaller studies looking at small groups, things like gratitude journals or free writing then have translated into benefits. And I think it’s pretty reasonable to call them out, to say lower stress levels, lower cortisol, and of course back then you support… if you hit those targets then you’re highly likely to be doing yourself a lot of good in the long run.
Ben: Yeah, it makes sense. I start off every day penning in my gratitude journal. If I do no other writing during the day, that at least sets the standard for me to have… we could talk about the woo-woo stuff like better empathy towards others and gratitude and a better mood, but ultimately I find that I engage in deeper breathing. I have not actually tested salivary cortisol or a urinary cortisol evaluation on the same day that I gratitude and repeat it a day that I’m not journaling, but I definitely feel the effects. Even this morning I woke up and I opened my phone and then kicked myself… I took it out of airplane mode before I picked up my journal and it was just blowing up with all these messages coz I wrote an article this morning for the blog and it went live and there were issues that I was supposed to go fix. And my first temptation was to just jump out of bed, head downstairs to my laptop, and take care of it, and I kept myself in my bed, partially because I knew my wife was laying there watching and we keep each other accountable with our gratitude journaling. So that helped out a little bit, but yeah I wrote and I felt far less stressed after I wrote, and there was enough time to still go down and work on the article. But yeah, I agree, a lot of people don’t realize even if they’re not authors for a living, how therapeutic writing can be. I know that when you wrote this book, Joanna Penn, your co-author, she was having health issues that you guys were kind of addressing as you wrote this book. Do you wanna speak to what kinda issues you were trying to deal with in her?
Euan: Yeah, and I think to be fair, she tackled most of them and has come to the realization herself, around I think a lot of these. I think we both got a lot out of writing the book and reflecting again on what we’re doing and what we’re not doing as well. But I think particularly, you mentioned at the start that her repetitive strain injury and she discusses this in the book, that she went through years of really debilitating, agonizing pains and they affected her all throughout her body and not just her hands and wrists and neck and back. And she really, I think the one thing that really made a huge difference to her, and she tried all the ergonomic stuff, was that she took a much more holistic approach… yoga, perhaps more than anything, and physical exercise and a regular physical habit is really what, particularly with the yoga and stretching and core strength, has really fixed her RSI for her. I think it was quite a transformation in that regard.
Ben: Now when you say RSI, can you explain because you guys go into, in the book, you go into RSI 1 versus RSI 2. Can you kinda fill me in a little bit more on RSI for our listeners who aren’t familiar with that and how it manifests in writers?
Euan: Yeah, so repetitive strain injury. Type 1 and type 2 which are not the most imaginatively named you’ve ever come across. Type 1s tend to be very specific conditions, you’ve probably heard of some of these, things like carpal tunnel syndrome where you get pains and numbness around your wrist and your fingers and your hands and tenosynovitis which, in particular tendons going into the wrist and in the hand, which is just an inflammation of those tendon sheaths. So the type 1, they tend to be very specific ones, they tend to have… more often than not, they tend to be very specific treatments. Carpal tunnel syndrome, it might be the using wrist splints or you can inject the area or you can inject the tendon if it’s a tenosynovitis… tendon sheath I should say if it’s a tenosynovitis, or there’s even surgical options sometimes that things like carpal tunnel syndrome that can fix it.
Ben: So what would you inject with if you’re gonna inject something for a repetitive strain injury? You’re talking about prolotherapy or cortisol?
Euan: Yeah, cortisol, corticosteroids, yeah.
Euan: Generally. There’s not always great evidence around all of those but they’re still regarded as fairly decent, fairly reasonable practice to try those before you… certainly something like carpal tunnel syndrome before you launch into surgery.
Ben: Yeah, have you ever heard of BPC-157 or… it’s a peptide, there’s another one called TB500 that they’ll inject into race horses for example for tendonitis.
Euan: Yeah, okay. I haven’t come across that.
Ben: I talked to a ton of people who have found that to be incredibly efficacious. I’ve even used it myself in elbow issues. I’ve assisted some pretty well known authors who have developed issues and hooked them up with these peptides and they just self-inject subcutaneously around the area that’s painful. And they always have them go… adjust their workstation ergonomically, get the elbows at 90 degrees while typing and ensure the computer is the correct distance from the face, etc. But to just get rid of a chronic inflammatory issue, those injectables seem to work pretty well in terms of just something you get… technically, it’s not sold for human consumption or human use. We can order it, you can inject yourself if you really wanted to.
Ben: But you’ve got type 1 RSI, and you said that would be like carpal tunnel syndrome, there’s inflammation, there’s irritation of the tendons. And then type 2, it sounds like that’s a little more nebulous or varied?
Euan: Yeah, that’s right. And type 2 just about encompasses everything else where you’ve got pain. It’s gone under lots of different names in the past, and it’s a little bit of a stigma around it, I think, as well. People sometimes feel that it hasn’t been taken seriously by the medical profession, and it’s been known as cumulative trauma or overuse injury. Sometimes the problem with these conditions which are very nebulous and there’s not just one thing that presents in all sorts of different ways, it’s that they’re just lumped together. And people have aching, they might have cramps, numbness, tingling, all sorts of symptoms and it can be in the hands, wrists, elbows as you’ve mentioned there, shoulders, even up to the neck, and headaches can be related to it. And I think the problem with those is they are a source of frustration for the patient because there isn’t a single other person that’s got it, because there isn’t a single answer to fixing them. There isn’t one thing you can point to and go “well, we could try injecting around here or here” or “there’s this surgery here we can offer.” They tend to be very much harder to get a grip of and to fix. I think, probably, it was the type 2 RSI that Joanna really had problems with when she was having difficulties, so she’s a good example of the right kind of approach probably to fix that which is very much more holistic approach where probably addressing your entire physical activity around your daily work is a really critical thing.
Ben: Right, so with RSI 2 that’s just general tightness, soreness, neck pain, headaches, stress, tension. It’s not necessarily a clinically diagnosable issue as much as just like a cluster of issues that arise in people who are just basically hunched over a laptop?
Euan: Yeah, that’s exactly it. And it’s probably as many varieties of it as there are people in the world, it’ll be completely individual to you, the symptoms you get and the symptoms you suffer. But no mistake about it, it can be incredibly unpleasant, incredibly debilitating and a source of really unpleasant chronic pain.
Ben: Yeah. The other thing is, and this is something I’ve noticed increasingly, is that breathing, when you’re kind of in that forward posture, hunched over position belly breathing, diaphragmatic breathing tends to be something that suffers and a lot of people don’t realize how related that is to things like peristalsis, movement of foodstuff through the digestive tract. I’ve noticed on days that are more stressful where I’m hunched over my laptop and I forget to belly breathe, I can tend to be more constipated the next morning and get digestive issues.
Ben: I’ve noticed psoas tightness that alleviates. Pain in the psoas that relates to or refers to low back pain that disappears once I stand up straight or begin to belly breathe or adjust my workstation. So even breathing seems to be very important, and then the other one, and you guys delve into this one in the book, is the actual screen that you’re using. Can you talk a little bit about why screens would cause problems?
Euan: Yeah, yeah. I think screens, you could… there’s all sorts of different ways they can cause problems as well. You can just go down the postural side of things where the position of… you talk about being hunched over a laptop or hunched over a computer. You get that screen position wrong, then you’re already setting off in a really bad direction. I think the other thing is your eyes and headaches particularly. We noticed that… Joanna ran a huge survey and got an enormous response from her community of writers. And they very generously completed a set of questionnaire on the symptoms they suffered from, and eye symptoms were remarkably common. It’s right up there in terms of people having difficulty, so that kind of blurry vision, dry scratchy sore-eyes where you feel red and irritable, the screens definitely are a big factor in that.
Ben: And I actually did a podcast about this, you guys get into it in the book as well, about this concept of blinking and how blinking is supposed to lubricate your eyeballs and tears help deliver oxygen and nutrients to the eyes and protect against… I think in the book, you call it a lysozyme that they protect infection by producing lysozyme and that heals damage to the surface of the eye and you’re supposed to blink 12-16 times per minute. And when you’re staring at a screen, you blink…
Ben: I think it drops to 5-6 times per minute?
Euan: Yeah, it can be really dramatic, the difference. Two and three times slower, and I think I wrote in the book, your eyeballs are just shriveling while you’re staring at that screen and it’s no wonder you get a few symptoms when you spend all day, or even just a few hours, a couple of hours, staring at a screen. I think actually it’s related to any activity. It can happen with reading as well, actually, it’s not completely just related to screens. Anything where you focus on one spot that’s a set distance for a certain amount of time can do it, and a lot of people sit far too close to their screens.
Euan: And there’s certainly some good evidence for that. You probably need to be a little bit further away, people who are sitting 50 cm, what that is in inches but I guess that would be about a couple of feet…
Ben: 50 cm divided by 2.54, right? So less than a couple of feet.
Euan: Yeah, a couple of feet. You need to be a couple of feet away from that screen, and there’s no excuses for that these days. You can easily zoom things in, increase font size, but the tendency is you hunch over that screen, you get closer and closer and sometimes you feel like your nose is just a couple of inches away from your laptop.
Ben: Yeah. The other thing is, and I dunno if you experimented with this much, and I’ll link to this, if folks are listening, go to bengreenfieldfitness.com/healthywriter. I did a podcast interview with this Romanian computer programmer who developed a piece of software called Iris. So I have that on my laptop now, and it’s kinda like that program Flux where it will decrease blue light from the screen depending on whatever time zone of the world you happen to be in at the time that you’ve chosen so that you don’t shut down your melatonin production and it reduces a little bit of glare.
Ben: But Iris, you can lower your screen temperature, you can automatically change the font of any website that you visit to be like an easier read like a samsara font for example versus a cursive font. You can decrease the screen flicker rate, it’s a pretty robust program. And then I also, while you and I are talking right now, I’m just looking out the window. I’m not actually looking at my screen, I’ve got this big picture window in my office so I just basically as much as I can, I don’t even look at the screen. I just look out the window and imagine you sitting there in your pristine, white lab coat, so…
Euan: [laughs] Yeah, that’s what I always wear. I wear it everywhere.
Euan: Obviously I wouldn’t… yeah, exactly, lab coat, I wouldn’t be without it. It’s actually the 20-20-20- rule, that you kind of look away from your screen every 20 minutes, focus on something 20 feet away for 20 seconds. If you do nothing else, that’s a really good way to…
Ben: Oh, is that actually a thing, 20-20-20?
Euan: Yeah, we don’t mention it in the book actually and I’ve come across it since, but it’s a good way of just remembering it. And of course the 20-20 thing, related to visions, fits nicely there. It’s just giving yourself a bit of a chance to change the distance that you’re focusing.
Ben: Yeah, okay, got it. So we know that we can adjust our distance from the screen as well as the type of screen and screen software that we use, that program I was talking about for example is called Iris. We know that, Joanna and I kicked this horse to death the last time we talked so I’m not gonna delve too deeply into this on my show with you coz folks wanna listen, but dictation is huge. So that’s been a life changer for me as far as allowing me to walk on my treadmill, to switch positions frequently. I use this Jabra 931 headset, Dragon dictation software, and like Joanna and I talked about in that previous podcast, you still have to go in sometimes and edit if you’re doing a serious article via dictation but for emails, it rocks. I can stuff a salad in my face or be doing isometric squats, like right now in addition to staring at my window while I’m talking to you, I’m standing on a wobble board, right? And so I can stand on a wobble board, dictate emails, etc. but we didn’t really get into a few of the other things that you guys talk about in this book, for example, active sitting. You get into the concept of active sitting in the book, things like these stability ball chairs, etc. and whether they’re a gimmick or a good evidence-based option. Can you get into what they’ve actually looked at in terms of trials on these type of active sitting options?
Euan: Yeah, so the best evidence seems to be, it’s a few years old now, it was a good systematic review done in 2012, I think. Might have been 2015, but I think it was 2012, which looked very much… all studies they could find related to active sitting, so it actually says it’s kind of sitting on Swiss balls or stools where you’ve got to do all this constant spinal microadjustments/micromovements, and the idea is that sort of helps you maintain your posture and that you’ll get some kind of benefit from it in preventing or treating back pain. And they really didn’t come up with very much, they couldn’t come up with any convincing evidence that it made any difference. So you could argue it may be a gimmick, but I’ll be a bit more generous than that in almost all the studies that when you look at intervention, particularly physical intervention for back pain, it’s plagued with really low quality evidence. Studies with small numbers, with sources of bias and it’s obviously… you can’t randomize controlled studies, you can’t blind someone to whether they’re sitting on a Swiss ball or not. You know whether you’re sitting on a chair or a Swiss ball, so you can’t… there’s no way to easily do these studies in a very effective way. So it’s a challenge with all the literature and there are medical evidence related to that pain, so my general feeling is that if you think it works for you and you’re getting benefit, then all power to you.
Euan: But overall, it’s hard to recommend them in a wholesale way. There isn’t great evidence.
Ben: Okay. Now what about these chairs that you sit in, and I even interviewed a guy from Finland about this that split the pelvis and cause you to sit up straighter. The one I have in my office is called a Salli Saddle Chair, and there’s another one that’s very similar but it’s a stool, it’s called the Focal Upright Mogo stool which you can even fold up and put in a suitcase and create a standing workstation on the go. What do you think about these kind of alternatives to sitting that naturally adapt to the shape of the pelvis?
Euan: Well I think it’s, again everyone’s very different, and I’m not aware of any evidence to point towards those from sort of a generality to say that it’d be good for all folks. But it’s one of those that if you can, if you’re seeing a therapist or they recognize a problem in terms of that particular postural challenge for you, then you may well get benefit. The problem is they can be expensive, can’t they and you don’t really know until you’ve given them a good whirl for a long while.
Ben: The Mogo stool is not super expensive, the Salli Saddle Chair gets a little bit… it is a little bit spendy, yeah absolutely. But between having those and a little balance mat and one of these skateboards… the one I have is called a Fluidstance, it’s like this kind of wobble board kind of thing I stand on, a little walking treadmill. I dunno how you feel about this but my philosophy is I switch positions as much as possible throughout the day, and I have lots of options.
Euan: Yeah, that’s exactly what I was gonna say. For me I suspect that’s more important than anything, and when I’m at work, I got this home-made standing desk, I’ve got a Swiss ball, I’ve got a normal chair. I pace around doing dictation, but it’s the variation that works for me. It’s the sitting still, not moving, not changing up at all that feels horrible.
Euan: And doing different things, I think that, for me and probably for most people, is gonna work well.
Ben: Now another thing you get into in the book is this concept of being ambidextrous with the mouse.
Ben: Yeah, ambi-mouse-trous. How would that work, exactly?
Euan: Well I think that it’s the fact that… I haven’t seen a shred of evidence for this so this is entirely expected, I think it’s just that we all use our dominant hands to operate our mouse or trackpad. And if that’s the… a lot of people in the server-base particularly, noted that if you’re starting to get a bit of RSI kind of symptoms, it’s often in that mouse hand that is the problem. That’s where you feel it, it’s that where you start to feel a kind of friction just moving your tendons around in your hands.
Euan: And I think it’s coz it’s such a fixed position for these tiny movements that can feel really uncomfortable after a while. So it’s just this very simple measure of just using your other hand and get used to using your other hand for something you wouldn’t otherwise normally do or you use it for at all. I certainly… honestly I don’t really get problems with either side, but I know that if I were to go to my Macbook just now and try to use my trackpad with the left hand, that’d be a disaster. But I think… I also know it’d probably take an hour or two and I’d start to get very comfortable with it. You probably wouldn’t notice much difference.
Ben: Well I can tell you that I never had any biomechanical issues associated with being an author and a blogger until I began to use a laptop. And this was like 6 years ago that I switched from a desktop with a nice external keyboard to a laptop, and the laptop is so convenient that I haven’t really given it up. And synching from the PC to the laptop and back and forth can be a little bit of a pain. It’s getting easier in this day and age…
Euan: Yeah, yeah.
Ben: But I’ll work in the office, then I wanna go to the kitchen table and quickly get to the airport with my laptop and it’s so hard to switch back and forth, but one of the things you guys get into in the book is kinda fixing part of it with the concept of an external keyboard. Do those really make much of a difference do you think and if so, what kind of external keyboard should people be looking for?
Euan: Well, I think that from the ergonomic perspective, and again this is a difficult study coz even from the ergonomic perspective, laptops are just evil, really. They just batter you, everything is in the wrong position. Your wrists are all cocked in the wrong direction, you’re looking down at the screen awkwardly, it’s really… I think anything you can do to stick a note if you’re a writer, or even a book, or whatever’s handy, and then using an external keyboard just helps you maintain it slightly, and you talked about how we chatted with Joanna about this in the past. It gives you a chance just to stick some of the good principles of ergonomics. And to be honest, after that, I’m not sure it matters too much what the keyboard itself is, and you can buy the cheapest USB one out there that probably will do the job if it gets you in the right position. I personally have got a couple of Bluetooth keyboards, I like to use an Apple one and I’ve got a very nice one I ordered from Kickstarter, I’m still waiting for it, with a retro feel. But that’s just an aesthetic thing, I don’t think it’s make any difference from an ergonomic perspective. What makes the difference is getting in the right position so that I can actually my… you know, have your arms parallel to the floor and have your wrists at a relaxed angle in a neutral sort of position and all those things. I think that’s how they really help.
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Ben: Does it bug you needing to carry an extra external keyboard around? I mean, have you found any portable, fold-up type of solution that works well as an external keyboard?
Euan: Yeah, no, nothing. Particularly with the Apple, Bluetooth ones are pretty lightweight anyway, but no there’s nothing particularly… I haven’t come up with, yeah you just gotta carry it around. To be fair, I don’t do that much travelling these days so it’s generally just pumping it into work and pumping it back again, so it isn’t that big a deal.
Euan: But yeah, you’re right. An extra bit of kit to carry around but I think if you’re starting to get pains, it’s definitely well worth the effort.
Ben: What about the little pads that you can put on top of the actual laptop like on the outer side of the track pad, have you used those at all?
Euan: I haven’t tried them myself. I’ve not been particularly plagued with problems myself. So yeah I think it’s one of those, there’s a lot of little ergonomic bits and pieces that you can try. The key thing for me with RSI is that you have to change what you’re doing. And sometimes that’s the messages that gets translated badly when someone goes to the doctor with type 2 RSI and they say “you have to start writing” or “you have to start playing tennis” coz you can almost argue that tennis elbows are kinda type 1 RSI, whatever it is. You kind of… the best is you really have to change what you’re doing somehow. You don’t have to stop but you have to change it up a little. And you have to take the pressure off the way you’re moving, and so you don’t have to do things… you don’t have to stop doing things, you don’t have to stop writing, you don’t have to stop using a computer, but you’ve got to alter something because you don’t want to get into that really deep, chronic, where there’s a really deep seated problem and trying to shit it, it becomes a bit of a nightmare. So yeah, those things do that, I think they’re incredibly useful but you’ve just gotta try and see what works for you. But if it changes enough, then it’s doing its job.
Ben: Okay, got it. Now one of the other things that you talk about in the book is the Alexander technique for fixing some of these issues.
Ben: What is the Alexander technique?
Euan: The Alexander technique has been around for a very long time, and we didn’t cover this in the book but I looked into it in some detail that it stems back into the 19th century. It was an Australian chap called Frederick Alexander, and he was an actor who had noticed that he went on stage and he had problems with his voice. And if somebody can project, he couldn’t get his voice out there, he’s looking at himself in the mirror and he noticed all this tension in his neck and associated with it, with his efforts to speak and when he was going to try to do his oration. And he also noticed that when he even thought about it, he started to get this same tension, and the whole idea of the Alexander technique is this kind of self-awareness to deal with posture and balance and mobility. And he sort of taught himself these exercises and in 1904 he came over to London and started rolling out to the people in London who were getting any kind of pain and back pain in particular. And he trained up a whole cohort of teachers, and I think he died in the 1950s in the end, but the Alexander technique just kept on going. And apparently described as not even being a therapy really, it’s almost like a self-awareness. I think one way to describe it, it’s almost like a practical physical application and mindfulness. So it’s a really interesting technique, and I think it has been shown to be quite effective, there was a good study in the BMJ, the British Medical Journal back in 2008 which showed it was effective for back pain. The studies since then haven’t been wholeheartedly endorsed, but again that stems back to some of the problems I was saying about studies into physical treatments for back pain.
Ben: I don’t understand, how exactly does it work? You’re just being more aware of a certain muscle, like there’ no actual therapy or systematization in terms of its application?
Euan: Yeah, you’re right. I’m not sure I know either and it’s very much a 1:1 thing where you get taught how to move and how to… I think breathing is a big part of it, maybe a lot of that getting that diaphragmatic and abdominal breathing right is a huge part of it. But they also teach you to recognize when you’re holding yourself in tension and when you’re holding yourself in effect in kind of damaging postures and positions. And to build that awareness and that recognition of what you’re doing, as soon as you feel them coming on or even if you react to a stressful life situation or you’re stuck in traffic or having an argument with somebody, you recognize you’re doing this then you can control your body. You see quotes from people that say it’s that recognition that you can do what you want with your body. You are in control of it, and actually building that self-awareness.
Interestingly, I’ve seen very little around but the medical practice work in had an Alexander technique practitioner that was about 5 or 10 years ago, we didn’t have it anymore but it was phenomenally popular with patients. And pretty good evidence to the back pain side of things, but yeah, you’re right. It doesn’t have… it’s much more this almost just self-awareness aspect to it. Honestly, I’m not an Alexander technique practitioner, and maybe it’s something worth exploring with one, but a really intriguing, interesting option for people who have back pain or just want to explore that whole posture-balance-mobility thing a bit further.
Ben: I wanna learn a little bit more about it. I was able to find a podcast on it that I didn’t actually download yet. But what I’ll do is I’ll link to it in the show notes. It’s from like 2010 but it’s an audio introduction to the Alexander technique and how it actually work, so if you guys are listening in, you go to bengreenfieldfitness.com/healthywriter, you can learn more about the Alexander technique. To me it sounds like a little… like at first glance or when you tell me about it, it sounds kinda gimmicky, it’s just better body awareness. It’s kinda like… I like Wim Hof but Wim Hof breathing is just fire breathing, right? So it sounds like this Alexander technique is almost just like being aware of your body but interesting. I’ll have to look into it a little bit more, it sounds fascinating. Now you also, or well technically it’s Joanna that talks about this in the book and I know that she’s unable to join us today due to some tech issues, but you guys do delve into diet. And she tells a pretty compelling story about this whole idea of eliminating these FODMAPs, these fermentable carbohydrates, from I believe it was her husband’s life and the profound changes that they saw when they removed FODMAPs from his diet. Was that something you were involved with or have you looked into this much, this low FODMAP diet for writers?
Euan: It’s not something I was involved with directly with Joanna and Jonathan, I think it was. I’m certainly aware of it as a kind of job in doctor, we see people… it’s used for irritable bowel syndrome so irritable bowel syndrome can present in a whole host of ways, and with a whole host of symptoms. The severe end of the spectrum can be really debilitating and really unpleasant, and clearly Joanna’s husband had some really horrendous symptoms. It’s a really nice section of the book, actually, explaining the difficulties they were having and just how much impact it was having on their lives. And then the remarkable story of the FODMAP diet that really did change their lives together in terms of just the improvement. The FODMAP diet’s only recently, just the last few years, has come into kind of the mainstream. And I think it’s been shown to be, some of the studies have shown, effective for about 70% of people with irritable bowel syndrome. There’s some good evidence around it, and in no shape or form is this on the fringes. I think it’s very much in the mainstream, the major challenge is just the difficulty with executing it.
Ben: Well, there’s a lot of foods. This is one of those diets where there’s a laundry list of foods to stay away from, apples to wheat and beyond. But she goes into how her husband would just lay on the couch exhausted at the end of the day from all the bloating and the gas and there’s nothing to fight it. And I read through some of those sections, if there’s one area like I mentioned how I found that deep belly breathing helps me a ton with my gut function, and I didn’t realize how tied deep diaphragmatic and deep belly breathing was to the comfort of my gut function. But actually, after reading about Joanna’s experience and her husband Jonathan’s experience with the FODMAP diet, two of the biggest culprits if you’re just gonna go with the 80-20 approach and the lowest hanging fruit… pun-intended, and something like the FODMAP diet, it is onions and garlic. And I actually, that was what pushed me over the edge to actually be really careful with onions and garlic, almost completely eliminate onions and garlic unless I’m using a garlic oil or garlic powder or an onion flavoring versus the actual onion or garlic itself. Huge difference in gas and bloating, I used to go to Whole Foods and I’d load up my Whole Foods salad with that. They had a really nice garlic cloves that I put sea salt on, a lot of their salads that are premade like the kale salads and spinach salads, they all have onions added to them. So I started to avoid those, night and day difference in bloating, gas, constipation, amazing difference. So yeah, it’s interesting how even these dietary adjustments can make a huge difference especially for writers who already are more susceptible to more gas.
Euan: Yeah, that’s right. And the section on Jonathan’s when he excluded onions and garlic, there was a near miraculous result for them. And I just say, we’ve taken the old [0:43:15] ______, that actually they’re at… there’s a couple of quick wins there for a lot of people.
Ben: Yeah. Now the other thing you go into that I guess is kinda diet related is this concept of psychotropics, things like psilocybin and LSD and where those fit into a writer’s life. I didn’t really realize that it was such a prevalent habit among writers to use a lot of these psychotropics but it sounds like it really is. And I don’t know what the status of all that is over in the U.K., but fill me in on what you guys discovered about cognitive enhancement and nootropics, what writers are doing and what your take on that is.
Euan: Yeah, nootropics. There’s certainly been a lot of interest I the nootropics. Again, in terms of the writers, we got a lot of comments in the survey about this. I mean if you were gonna go take a cognitive enhancer, then we’re all using… mostly everyone’s using coffee.
Euan: So caffeine. Nobody’s exempt from this in that regard, and obviously it’s a very smaller number who are going on and using the other kind of stimulants and amphetamine-like substances. Most of the research around this is in students, actually, probably unsurprisingly. But then that’s often the case just because they’re handy for researchers, I think, more than anything else. But the statistics in the U.S.A. are anything between 5% and 35% have lifetime use of trying serious stimulants like Adderall or Modafinil, and sort of amphetamine-like salts or Modafinil. The numbers are quite big in terms of people that have tried them at any point in their life. And I’ve worked at addiction quite a lot as well, actually with people who have addictions to things like heroin and cocaine and other substances. My general view as a doctor as well that there’s almost no such thing as a free lunch when it comes to medication. Almost everything has a… there’s an upside. But there’s a little bit of evidence for Modafinil as a cognitive enhancer.
Ben: Yeah, I’ve certainly seen a lot of evidence for Modafinil. The only issue for Modafinil I’ve found is it’ so efficacious, it can keep you up for long periods of time. It can make you a little bit too hyperactive, it’s difficult to sleep after a day of using something like Modafinil, in my opinion, versus… I mean I’ll shoot straight with you, I’ve microdosed with psilocybin and I’ve microdosed with LSD and I’ve used some of these nootropics like… there’s one called Qualia that I really like, (a.) because it’s legal and (b.) because it’s got 42 different brain nutrients in it. Seems to work pretty well, I’ve written an article about it and I’ve called it the god pill in articles.
Ben: But yeah, I think that dependency is an issue. That’s the one thing is I never liked to, as a writer, wake up and feel like the only way I’m gonna put together a quality article or quality chapter of a book is whether or not I have access to my nootropic, when in fact things like breathwork and meditation and fresh air and large amounts of natural light exposure, etc. can help out quite a bit. But it is very interesting, the number of authors now who are actually relying on nootropics, that fantastic fiction book that someone listening in might be reading right now might have been entirely written under the influence, right? I guess that’s the way that a lot of artists actually create great art.
Euan: I think that’s right. Be careful about that stereotype coz that’s something we tried not to get too much… we tried to look into in the book a little bit about that creative stereotype, that you could only produce great art by drinking heavily if you’re an alcoholic or fatally flawed in some way.
Euan: Or you have to use substances. Actually, most people I think are out there creating very happily by doing all the other cognitive enhancing things you mentioned like getting some fresh air and getting regular breaks and exercise and eating a balanced diet and getting enough sleep. And that’s always the thing I think about these amphetamine substances like Adderall or Modafinil or whatever it is, actually you’re always trading off against sleep more often than not with these, and that’s kind of one of their core actions is to keep you alert. And you’d be hard pressed not to have your sleep perfected in a slightly damaging way, so there’s certainly a long term trade off there. I can understand why people, why students use them in very limited times when they’re under particular stress. But as a long term option for maintaining a creative life, I would have some anxieties about that.
Ben: Yeah, it’s one of those things where I think it’s all in moderation, something I might use one or two times a week for example. Now there are a few little things that I highlighted in the book that I want to check in with you on and get some practical takeaways for people. Screen height, people are confused about the actual screen height and what it should be at when you’re looking at your screen to maintain normal biomechanics and whether it varies depending on whether you’re typing versus whether you’re reading. Because I interviewed one guy who will adjust his desk up and down whether he’s typing or whether he’s reading. I’m curious on what’s your take on that and if there’s any rules about high the actual screen should be that you’re looking at relative to your head to maintain proper cervical neck posture, for example.
Euan: Yeah, the thing about everyone’s necks is they’re all a little bit different in terms of where the neutral position is. So I would be really careful about offering any kind of generalizations about the right position. My understanding is just that the neutral position will usually result in you looking just slightly down towards your screen in the natural position. But that’s so vague, I don’t think you can offer in terms how many inches that would be or for any given distance. People do have different curvatures in their cervical spine and what’s gonna be right for them and if you age that can change considerably. If you’ve got a bit of osteoarthritis in your neck, then the advice is gonna be completely different or if you had previous neck injuries. So I would be very… I think you gotta go with what feels reasonably comfortable I think, but bearing in mind that it’s probably, if you look straight ahead and slant down, that’s usually where the neutral position for the neck is.
Ben: That’s what I try to do. I try to make my eyes level to about the top of the screen close to it.
Euan: Yeah, absolutely. I’ve absolutely seen that, the top of your monitor or whatever that is, just let your eyes look across them. I think actually, Joanna put out a video for The Healthy Writer including my stand-up desk setup. She said sort of that we can and someone said they picked it up, mine didn’t look very comfortable and I was in the wrong position, I was looking too far down. Maybe a bit but I certainly didn’t get any neck problems and I think that’s more or less what I base mine on is that position. Going back to your point about the… I do think the stand-up desk thing or the treadmill desk is an amazing option, rather than even some of the dynamic sitting, bits and pieces in terms of the positioning of posture and getting in the right position. Actually sometimes, just being stood up in the treadmill’s an incredible…
Euan: There’s some great evidence that treadmill desks in terms of improving hard numbers like your blood glucose and your cholesterol and other things like that, your actual blood work improving and studies that have shown improvement in bloodwork in people using treadmill desks. So they’re right up there in my number one recommendation, if you can manage to make it work in your work and home setup, whatever that is.
Ben: Yeah, I use a manual treadmill because I don’t like all the beeping and all the wires and all the electricity from the engine-based treadmills. But yeah, I have a manual treadmill called a TrueForm treadmill, and that’s what I walk on and what I like about it is it allows me to sprint, one of those treadmills you can actually run on. A lot of crossfitters use this thing coz it forces you into a proper biomechanical position when you’re running, it’s like a curved treadmill. Spendy, but it works like gangbusters.
Euan: Yeah, so let me ask you, I saw it in the studies I was reading that there was a little bit of a kind of cognitive issue with using treadmill desks, it was harder to concentrate or doing the same level of work because you were kind of… I think if you chewed gum…
Ben: Oh, yeah. If I’m gonna be doing deep work, deep writing, I’m not on the treadmill but for a lot of my phone calls, consults, meetings, yeah dictating emails, like a little more surface level work, works amazingly. It also works well when I need to… somebody’ll shoot me a video, let’s say like that Alexander technique we were talking about. I’ll probably find a YouTube video later on and watch that, and when I’m doing something like that, I’ll put the video on whatever, 1.5 speed so I can get through it at a decent rate, then I’ll just hop on the treadmill and I’ll walk at a pretty brisk rate while I check out the video. It’s a way to kill two birds with one stone and honestly I’ve gone through entire courses. I’ve downloaded Udemy courses on my treadmill and just walk two hours while going through a course or while we’re doing a technique.
Euan: Yeah, I was at a conference at the weekend with some writers and one I was happy to talk to, one young lady and she said when she gets in the zone when she’s writing, sometimes 200 steps in a day. A complete disaster in terms of any movement, and so might be using a kind of modern like, just gotta grasp every opportunity to get moving because… trying to stop us moving and trying to make us eat too much as a general rule, the world we live in.
Ben: Oh yeah, I had two 1-hour calls on my treadmill yesterday, I track all my steps using this ring, it’s called an Oura ring, I’m pulling up my data right now on this ring. And I’ll tell you, just two 1-hour calls, I did, let’s see, I had 16,000 steps yesterday, and most of that was just those couple of calls, so that’s pretty easy if you think about it, just walking for a couple of hours to hit that step count.
Euan: Oh yeah, that’s just… I mean for most people, getting that step count using that kind of option, that is just gonna blow you away in terms of your fitness. It’s gonna make massive inroads into anybody’s wellbeing.
Ben: Yeah. One other thing I wanted to ask you as well was this idea… you co-authored this book, you co-wrote it with Joanna. In terms of co-writing, did you come up with anything interesting, any tips for co-writing, for people who may wanna write a book with an expert or something like that. This isn’t really health-related question so much as a logistical-related question. What’s it like to co-write a book?
Euan: It was good. I would recommend it, I think collaboration and co-writing is the way that very much… to sell an indie author Q&E is currently looking just now as incredibly good option. And I think it’ll work for any entrepreneur or anybody thinking about it. One of the things I did more than anything was keep me honest to my deadlines, so I couldn’t… writing for yourself, there’s always that possibility you can slip so when you [0:54:45] ______ to someone else, it was absolutely… there was no escape from that. And I think that’s the one thing we were very careful about was we did have, we went through a whole process of getting to know each other of at least each other’s writing so that we knew that we were compatible and could get on. So there was an initial process that we went through where we communicated and sent a sample piece of writing backwards and forwards. And then we then had a meeting after that which we very much set out our table of contents and we knew exactly what we were headed for. Now that changed a lot through the project but we were fairly fixed in length of book, length of chapters, what was going to be in the book from a very early stage. There was timelines set for that and deadlines, but there were breakpoints as well, we both had times where life just got in the way a little bit and so we moved things back and we’re flexible. But having all those things in place was really effective in terms of getting us there.
Ben: Yeah. Did you use Google Docs or Scrivener, what kind of co-writing software or platform did you use?
Euan: Yeah, so we basically… we used Scrivener but we used Google Docs to meetings, and this is the kind of the agreement about timelines and other notes, so that was just shared in Google Docs, and then we used Scrivener. And we both write in Scrivener ourselves anyway, but we very much had periods where we handed over the baton to each other and then had a couple of weeks where I would have it and then a couple of weeks where Joanna would have it. And then we zipped it up and emailed it to each other, so we didn’t attempt to share it via Dropbox and have us both… or whatever cloud service you’re using, and have us both going in. I know that Scrivener’s quite good in that it will warn you if someone else is in there and so you can avoid the disaster of corrupt files.
Euan: We didn’t go there, we just completely separated our individual… and we both have plenty of other things going on, and so that was part of the organization process was blocking in when I would have it and when Joanna would have it, and then emailing the Scrivener file backwards and forwards.
Ben: I absolutely love Scrivener for writing and for keeping track of manuscripts, chapters, research, etc. but the one thing that I don’t like is it’s not very good for co-authoring or for co-writing. I really haven’t found anything other than Google Docs that works well for that. If people are listening in and they’ve got good co-writing/co-authoring solutions, I’m all ears because a lot of times when I’m writing a book, there are people jumping in on the project, like I’ll have a scientific editor who I’m bringing in to look up some research for me or I’ve got someone doing a beta-edit or developmental edit, and it’s constantly a process of me exporting from Scrivener into some kind of a document, sharing with them, then editing, then me importing it back into Scrivener. So yeah, I’m sure there’s a better solution out there but I do really like Scrivener for just the writing process itself. There’s some kind of a cognitive switch that happens writing in that versus say Google Docs or Microsoft Word.
Euan: Yeah, we love Scrivener. And it’s a British software company so we’re super fans of it.
Euan: But it is the one thing… it would be the killer app to end all apps if you could collaborate with it. Scrivener collaboration version would just absolutely… just coz there’s nothing else out there that can come close at the moment, not that I know either so I’ll be listening in if anyone comes up with anything.
Ben: Absolutely, leave a comment if you have any ideas for collaboration software that’s similar to Scrivener. If you do, let me know, I’ll go talk to Tim Ferriss and a few other folks who also use Scrivener and we’ll dump some money into the project to make it happen.
Ben: Well, Dr. Lawson, this is really fascinating. This book is called “The Healthy Writer: Reduce Your Pain, Improve Your Health, and Build a Writing Career for the Long Term”. Like I mentioned, Joanna talked with me last time quite a bit about dictation so go listen to that other podcast episode if you wanna know how to train your computer and how to dictate efficiently and effectively, and then also grab this book coz it not only goes from meditation but a lot more, and I’ll also put articles and resources in the show notes over at bengreenfieldfitness.com/healthywriter for everything else that Ian and I talked about… sorry, Euan and I talked about [laughs], including articles I’ve done on these peptide injections, Iris for creating a healthy screen, my podcast with a guy from Finland who designs these Saddle chairs, the wobble board I use, the Scrivener program. I’ll put a link to some more information on this Alexander technique as well, so everything you need will be over at bengreenfieldfitness.com/healthywriter.
And in the meantime, Euan, thanks for coming on the show and sharing all this stuff with us man, it’s fascinating and hopefully it’ll help a few people develop healthier writing habits.
Euan: I hope so. It’s been my pleasure.
Ben: Alright folks, well I’m Ben Greenfield along with Dr. Euan Lawson who co-wrote this book along with author Joanna Penn, The Healthy Writer, signing out from bengreenfieldfitness.com. Have an amazing week.
Do you suffer from physical pain relating to your writing life?
Are you struggling with back pain, weight gain related to sedentary working, anxiety, depression, sleep problems, neck pain, eye strain, stress, loneliness, digestive issues, or repetitive strain injury?
These are the most common issues reported by writers and if you struggle with any of them, you are not alone.
Let's face it: writing (and especially typing on a computer) is not a physically healthy activity, but if you want a long-term writing career, then you need to look after your body.
Awhile back, I featured author Joanna Penn on the podcast. Joanna has been through her own pain journey over the last six years. She used to get crippling migraines that sent her to a dark room, and back pain so bad that she couldn't sleep, as well as stress levels so high that she wasn't able to breathe normally.
Now, her back pain, migraines and repetitive strain injuries (including elbow pain) have almost gone completely, and she manages her writing life in a far healthier way than ever before.
I was planning on having her share her personal journey and insights with you in her new book “The Healthy Writer” once again on the podcast. However, due to some technical difficulties on her end, she was unable to join the call.
However, I was able to talk to her co-author for this book, Dr. Euan Lawson. Dr. Lawson shares his insights into how you can reduce pain, improve health and build a writing career for the long term. Dr. Lawson is a British medical doctor and a Fellow of the Royal College of General Practitioners. He's ex-British Army and enjoys fell running.
During my last podcast discussion with Joanna, you learned:
-How Joanna developed chronic repetitive motion injuries in her wrist, and why ergonomic keyboards and an ergonomic computer mouse weren't working for her…
-Why Joanna decided to go way above and beyond simply using a standing workstation or treadmill desk…
-How Joanna is simultaneously working on multiple books while also training for an ultramarathon…
-Whether you can really, truly be creative while standing or walking, and why it's a myth that you need to sit to write effectively…
-The exact tools, microphones and software that Joanna has found to work very well for dictation…
-A book that will teach you exactly how to dictate quickly and effectively…
-How to “train” your computer to recognize your voice and accent…
-How to enhance productivity with ambient noise and focus apps…
-And much more!
Resources from the previous episode:
–Kevin J. Anderson (an author who dictates while walking 4+ hours per day)
During today's discussion with Dr. Lawson, you'll discover:
-Why writing is good for your health… 8:00
-The kind of health issues Joanna had to deal with as a writer… 11:30
-Why you need to know about type 1 vs. type 2 RSI… 12:45
-Why screens can cause problems and the “20-20-20” rule… 18:15
-The concept of “active sitting” and whether all these “core chairs” and sitting on giant exercise balls are a gimmick… 23:45
-What it means to be ambi-mouse-trous… 27:30
-What kind of external keyboard Dr. Lawson uses… 29:15
-How to fix ergonomic issues using something called the “Alexander technique”… 35:15
-Why writers experience great relief from gas and bloating by utilizing FODMAP… 40:00
-Why Dr. Lawson and Joanna wrote about psychotropics in the book, and how many writers are using them… 43:30
-How Ben walks over 20,000 steps… 52:00
-The software Dr. Lawson and Joanna use to write… 55:45
-And much more!
Resources from this episode:
-Ben's Christian Gratitude Journal