It’s been a while! Lots of exciting things going on, and as I write this note during a few train rides to Manhattan, I thought to share something that has come up several times the past few weeks.
As some of you may know, I’ve been going out without a coat for most of this past winter (when outside 15-20 min and under). Many people have asked me why, and now’s a chance to more systemically unpack the bewilderment from a more holistic perspective.
S.T.R.O.N.G. Note: The reasons boil down to 6 things so far: 1) Potential health benefits. 2) Getting used to being uncomfortable as a way of life. 3) Being ‘independent’ and more minimalist. 4) To recognize, in a strange way, how fragile we are. 5) The awareness ("mindfulness" aspect) that may come with it. 6) A reminder of what it is like to be homeless without a shelter, and allows one to witness only the smallest glimpse of the drop in the freezing bucket of what those in the Holocaust and others in Siberia camps must have had to go through. [Added Comment on 2/11/14: I Just want to briefly address two points: the history of why I came to cold exposure in the first place is different from the above 6 reasons of what sustains the current practice (though related). And regarding the Holocaust point - no doubt that touched a nerve, and I apologize if peeps took any offense in going overboard. I guess I was just being extremely honest of the reaction I had when hit by the frigid windchill gust: my first reaction was to feel bad for myself, then I thought how trivial it is in comparison. Remembering these horrors of the world is vital and reminders can be received through education, tradition, etc. And sometimes an actual physical experience can be a trigger to remember, putting in perspective the important things we value in life.] And it is with that that I begin a more full explanation. (So If you want to read the history first, skip to the bottom.)
1) Potential health benefits
I know the burden of proof is on me here. After all, isn’t there substantial literature on getting sick when you are outside? So the first layer of the conventional wisdom is that coldness actually makes one sick. But as is often debunked, the cold inherently has nothing in it to make you sick. Rather, the rhinovirus (‘common cold’) may be transmitted more easily through dry colder air. And in fact, the fact that we spend more time in doors during the winter might cause greater transmission of germs person-to-person, which causes the issue and perceived uptick in sickness during the winter. While this would seem to show the cold does nothing to make us sick, there is still a legitimate concern - though the cold may not directly make one sick, it may reduce your immune system, making oneself prone to getting sick. Both anecdotally and scientifically, the certainty of this theory is suspect.But to understand why let us remember the fact that what it means for something to be “healthy” or “unhealthy” is not clear cut. Food, activity, the environment one subjects oneself to (one’s “lifestyle”) affects the body in many different ways. When we say “healthy”, it’s about having the body’s state altered in a positive way. And because the body’s state is comprised of thousands of metabolic processes, a positive state is one in which on the whole the sum of many things going on in the body are positive. There are then short term and long term considerations, and if something is positive in the short term, that does not mean it is positive in the long term. And lastly, what is “positive” is not always clear. If a particular action causes the body to in the short term get strong, but in the long term can be mapped to increasing susceptibility to a variety of pathogens, would we say it’s positive or negative? Well, that depends on the criteria one has and the goals on has.
So to summarize this brief interlude, here, to say something is healthy is to say: on the whole, the sum of the bodily processes are affected in such a way that by some standard or another we find it to be positive during a particular moment in time, whether short or long term. Now, that’s pretty darn complicated. And if I want to know whether a banana is healthy having to do mental gymnastics to figure these things out on a case-by-case basis would be ridiculous. To cut the complexity and get a general approximation of what is the healthy approach we can adopt what I have advocated to be the holistic approach. That is, look at things on the whole, on an individual level, and see how it goes. Just because cold-exposure things may be healthy in certain circumstances for me with a particular lifestyle, it doesn’t mean that someone else with a different (epi)genetic profile and lifestyle is healthy.
Ok, with this nuanced view in mind, let us revisit the scientific evidence and then more anecdotal considerations.
Because I am trying to defend against the concern that cold exposure may make one sick, it is little surprise that a defense of cold exposure (with a nuanced and holistic take) must look at the immune system. There are a few studies that I have read up on that may not only be neutral, but it may help the immune system.
- “Immune system of cold-exposed and cold-adapted humans.” Abstract Excerpt: “It was concluded that the stress-inducing noninfectious stimuli, such as repeated cold water immersions, which increased metabolic rate due to shivering the elevated blood concentrations of catecholamines, activated the immune system to a slight extent. The biological significance of the changes observed remains to be elucidated.” http://www.ncbi.nlm.nih.gov/pubmed/8925815
- “Cold Exposure Human Immune Responses and Intracellular Cytokine Expression”. Abstract Excerpt: “It is commonly believed that exposure to cold environmental temperatures depresses immune function and increases the risk for infection…Based on the review of the literature, there is no support for the concept that cold exposure depresses immune function.” http://oai.dtic.mil/oai/oai?verb=getRecord&metadataPrefix=html&identifier=ADA411099
- “Immune changes in humans during cold exposure: effects of prior heating and exercise”. Abstract Excerpt: These results indicate that acute cold exposure has immunostimulating effects and that, with thermal clamping, pretreatment with physical exercise can enhance this response. Increases in levels of circulating norepinephrine may account for the changes observed during cold exposure and their modification by changes in initial status.” http://jap.physiology.org/content/87/2/699.short.
- “Cold exposure and immune function” http://www.nrcresearchpress.com/doi/pdf/10.1139/y98-097 (slightly questionable take on the matter)
- “Possible stimulation of anti-tumor immunity using repeated cold stress: a hypothesis.” Abstract Excerpt: “This paper hypothesizes that brief cold-water stress repeated daily over many months could enhance anti-tumor immunity and improve survival rate of a non-lymphoid cancer.” http://www.ncbi.nlm.nih.gov/pubmed/17999770
- “Possible use of repeated cold stress for reducing fatigue in chronic fatigue syndrome: a hypothesis." Abstract Excerpt: “The increased opioid tone and high metabolic rate could diminish fatigue by reducing muscle pain and accelerating recovery of fatigued muscle, respectively.” http://www.ncbi.nlm.nih.gov/pubmed/17958903
- “Adapted cold shower as a potential treatment for depression.” Abstract Excerpt: “Practical testing by a statistically insignificant number of people, who did not have sufficient symptoms to be diagnosed with depression, showed that the cold hydrotherapy can relieve depressive symptoms rather effectively.“ http://www.sciencedirect.com/science/article/pii/S030698770700566X
- And nice sources that I found some stuff: http://www.marksdailyapple.com/cold-water-therapy/#axzz2s0ON1QIp and impossiblehq.com/cold-shower-health-benefits
Also, the increase in endorphins might be one of those things that is positive (desired) in short term, and whether stimulating that chemical pathway translates into positive/neutral/negative long term benefits is unclear.
There are two concerns we need to address at this point:
1) Doesn’t the body need to work at an optimal temperature (for enzyme, and just general functioning)? And if exposure to cold reduces that optimal temperature, surely that couldn’t be healthy, right? My uncle sent across this study- https://student.societyforscience.org/article/cold-environment-suppresses-mice-immune-system-can-foster-cancer-growth - showing the potential negative aspects. Even assuming that the response to cold exposure in mice is analogous to that in humans, and further assume that the study is replicatable multiple time with other scenarios, I wouldn’t argue to the contrary. But let us not forget that I’m not advocating to reduce one’s core temperature beyond reason. Just like I’m not advocating for people to take 2 hour long freezing cold showers. Long term exposure to stress is not the goal here. The key is to do just enough cold exposure to elicit this potentially beneficial response. For me, that depends on the temperature. The past couple of days I put the shower all the way on cold and after a minute and a half I had severe brain-freeze of sorts. And that’s not something I recommend and I overdid it. I've also tried contrast showers - 1 minute freezing, 1 minute warm.
2) I would be foolish to say this is for everybody. I think that depending on who you are, it matters. Not only that, but recalling the holistic approach, even for the same person it might not work. The fact that I eat healthy foods, and don’t smoke or drink alcohol helps. But the fact that I’m sleep deprived doesn’t. And so when I was in the middle of writing 85 pages worth of final papers a few weeks ago, while I continued to go without a jacket, I tried not to add additional stresses on my body, and I focused a lot more to get in more veggies and fruits. Also, I would be sure to bring a jacket with me in my bag. So if I was in class and cold, I would wear the jacket to avoid further stress on the body. Furthermore, if I did intense exercise that day, I know not to stress my body any further if I don’t think I can adequately recover. This isn’t an exact science, as you might imagine. Everyone is different. Which is why I opt for this kind of holistic approach.
What it comes down to is stress on the body— it's not necessarily bad. With running, just enough stress on the muscles and cardiovascular system and the body responds and gets stronger. Too much, however, and you overtrain and get injured or sick. We can analogously think of the body’s response to cold showers that way. Just ‘enough’ of a stressor and you can elicit and beneficial response.
Up until this weekend, when I spoke about the cold-exposure running analogy, I wasn’t prepared to actually claim there is the same physiological mechanism as work, or at least an underlying scientific idea. It was more just relating to people an idea that made the whole cold-exposure idea palpable (and it was enough to satisfy an M.D. who I was justifying my practice to a few weeks ago).
After I wrote up 90% of this blog post, I came across a fascinating article, essentially spelling out this link in terms of stress. It’s called: hormesis
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2248601/
http://www.ncbi.nlm.nih.gov/pubmed/17318365
Todd Becker of gettingstronger.org has a ton of stuff already written about this stuff. And I think I came across his work a while ago, but never put two-and-two together. I highly recommend peeps check out his eye-opening Incredible work!
There’s also the notion of immunotherapy and a recent study showing a potential reversal of peanut allergies: online.wsj.com/news/articles/SB10001424052702303519404579352952075880322 - building up a little bit over time.
I have just scratched the surface in understanding this area of hormesis and the body's biphasic response. I had a lot more planned to say here, but I think first I gotta do more reading and more research. But thus far, encouraging stuff!
Anecdotally - This is one of the things that someone can just google. There are many, many people taking cold showers and few report getting sick. Most in fact, to the contrary, feel great, and see it as an integral part of their day. There are many forums, and articles on this. Here are a few:
http://www.thefeelgoodlifestyle.com/how-i-crushed-the-30-day-cold-shower-challenge-the-great-life-secret-i-discovered.html
http://forum.bulletproofexec.com/index.php?/topic/259-cold-showers/
http://www.davidicke.com/forum/archive/index.php/t-206331.html
It's important to note here that general exposure to the cold outside likely produces different effects on the body from a cold shower. I have a hunch about the scientific differences, but it remains to be elucidated. And while this first point needs to be qualified in this light, the other 5 reasons below apply similarly to cold showers as they do to general cold exposure.
Anyway, up to point number 2! This blog post is getting quite long.
2) Getting Used to Being Uncomfortable as a Virtue
This second reason has encountered a bit more resistance. Here I advocate for the fact that getting used to being uncomfortable can be a good thing. I say “uncomfortable” as in slightly painful or displeasurable (here I am dealing with the physiological discomfort with pain/pleasure, not as much emotional aspect - though there are surely parallels in that domain as well.).There is the chemical property that things tend toward disorder (entropy). There is perhaps a sociological feature (the term as an artificial useful construct) that people tend towards what is comfortable. But I would say that this tendency may not always serve our best interest. I’m sure we’ve all had those times where we turned down opportunities or declined certain activities because we thought it would be uncomfortable. Pain and discomfort is no doubt an important sign, but it should not overwhelm us. In cold exposure, it is a sign our body is being exposed to a degree of stress. But we need not have that feeling overwhelm us, and we should evaluate the degree of stress to how important we seek the particular thing in question. Quite simply - it is positive to be able t do things even though it might cause us discomfort.
We should be able to do things even when uncomfortable. One might object - who’s the “we” or “I” that is separate from the desire for comfort? Aren’t we part and parcel of this comfort feeling, how could we ignore who we are? This objection stems from my presentation of setting reason apart from desire; so while we desire comfort, our reason of wanting to do something else should trump. This leads to then the perceived assumption that one can stand beyond these “wants”, and actually has the ability - by reason 0 to choose something else. But this need not be the case. Even if we cannot separate reason from desire. And if the desires (or more broadly passions) are all that we have, doing the more important thing can just be the desire for the important thing trumping the desire for comfort (or aversion to discomfort). For those political-science folks out there - we would say that this position is consistent with Hobbes picture of desires and the passions in Leviathan, with reason just as a tool for weighing the desires. (See chapter 6 of Leviathan for stuff on the passions.)
But there is a further reason why shouldn’t tend to what is comfortable. Doing the comfortable thing is we would say easier than doing the uncomfortable thing. Yet, the very challenge in doing what is uncomfortable might be said to a positive thing in itself.
In Sovereign Virtue Ronald Dworkin discusses what he calls the “model of impact” versus the “model of challenge”. I would argue that in terms of the individual person, what I believe matters most in life is not how much you can do, but the challenges one has overcome. In high school the way I thought about this issue was like this: if we had some sort of “success-o-meter”. And you start out in life at one particular level, and ended up at another level. For someone who went form 20-80 I thought (and still do in this extremely linear and oversimplified way) more impressive than someone who goes from 70-100, and definitely more impressive someone who goes form 100 to 90. I say “more impressive” as in that it is perceived to be more in line with this kind of “flourishing life” (eudaimonia) we seek to live. At the end of our lives, what matters not what has come to us, but what we have overcome in virtue of the challenges we’ve faced.
A nice resource I came across that relates cold showers to the uncomfortable aspect: http://www.thehackedmind.com/7-reasons-to-take-cold-showers-and-1-that-really-matters/
It’s important to note here that when one contextualizes the aspect of cold exposure, it can change your own pain-response towards it (as has been discussed in previous post: http://blog.trainerjb.com/2012/10/school-lunches-and-contextual.html). Someone who enters a cold shower thinking of how much it’s going to hurt will probably be conscious of more pain than the person who enters the shower thinking of the benefits and a ll. Learning to compartmentalize the pain is important in this aspect as well.
And it’s not about asceticism or anything like that. To the contrary, it gives life more vivid colors and opens up doors through this physiological/mental training. It - ideally - allows one to do more things that one wishes in life. For more stuff on that, check out a previous post: http://blog.trainerjb.com/2013/06/two-concepts-of-self-discipline-and.html.
3) Independence and Minimalism
This one is a bit of a stranger reason, one I do not think everyone would necessarily agree. I just like to feel less reliant on things. That was the driving sentiment behind a post in the other blog that I wrote a few years ago. (http://arelativereality.blogspot.com/2010/09/running-sneakers-and-drugs-abuse-of.html), where I saw drugs and support as against this spirit of independence. It’s a matter of practicality. If I’m in a rush somewhere, and can’t find my coat, it’s not a big deal and I’m not going to get worked up about it.One criticism might come from advocates of biohacking. What is the real line between you and the outside world? Why should a smart-drug make anyone less dependent than eating foods?
But it would be a bit premature to see food as a dependency. It is instead a necessity to keep oneself healthy and functioning. And the point here is you do not need the smart-drug, you do not need the coat - and insofar as you don’t need it, creating a perceived need for it fosters the aspect of dependency. Surely, though, you are dependent on what you need. And that may be true. But The less necessary something is, the more we can say it is a dependency that we should consider jettisoning. (As an aside - I would consider myself as “in principle a holistic quasi-biohacker”. I’m into leveraging the human body to do incredible things, but things that work with the body.
So what’s that mean for our coat-bearing friends? Well, the question is how much of a necessity it is. The more of a necessity it is, the less we would see it as a dependence worth jettisoning. But as I’ve argued above, it might not be as necessary as we think. And insofar as it is not that necessary, yet has become a dependency, it is up for question whether or not to bail on it.
One again - I am not advocating for everyone to jump ship on their coat. Coat’s are important to survive and thrive in a cold environment. But the question is how necessary are they in every circumstance. But for me, at least, 15 minutes in brief cold temperatures of 25-35 degrees is fine, and it’s not necessary to stay functioning nor healthy. With this nuanced holistic perspective, we must recognize that everyone’s level of necessity to stay healthy will need to be tailored.
Being independent of "things" is also part of a more minimalist approach to life. Less extra "stuff" allows us to focus on the things we care about, and keep our attention on what matters. Part of being mindful, I believe, as well. (Mindfulness discussed in point 5.)
4) Fragility's Dialectical Relationship
This point is the flip side to the above concern on independence. Going out in the cold, and exposing oneself to cold water, is a reminder that for all the incredible technological accomplishments and incredible feats - from the Pyramids in Egypt to landing a human on the moon - we are fragile human beings. If our core temperature is tipped one way or another by a few percentage points, the entire “world” as we see it hangs in the balance. Recognition of this makes the colors of life all the more vivid. Every moment could be our last, if you will. But like most things, there is a dialectical relationship, with this fact of fragility eliciting a certain response for some. And for all the awe-inspiring fragility of human nature is the corresponding response to respect this fact while seeking to be as “anti-fragile” as possible. I am referencing here “Antifragile” by Nassim Nicholas Taleb.I have not yet read the book (though I listened to a talk with Daniel Kahneman and him (http://www.youtube.com/watch?v=MMBclvY_EMA) And I do not propose here to outline Taleb’s ideas (though I hope to read the book real soon). I just want to give due recognition to the general concept that I gleaned from reading reviews on and talking to people about his book. The notion of antifragility here is not about being resistant, but getting stronger from the things that make something fragile. Something that is fragile if it is susceptible to these kind of minor, random things. A glass vase on a table might seem strong if you grasp it, but should someone pull the tablecloth too hard, the vase will shatter into thousands of pieces. Something that is fragile gets stronger from that random pull of the table cloth. We must set ourselves up with options n the world such that if something unforeseen happens its not that you are resistant to the change, but you can capitalize on it.
Less dependency leads to more optionality, as when you are not dependent on something you can make a decision without having to take the matter into account. When you are dependent on something, on the other hand, you are limited by the options. Being less dependent on a coat - or rather, less dependent on being warm at all times - leaves options open in the future for when you are cold. If some opportunity comes boy, whether or not it will involve you being cold is not only not a factor (that would be more appropriately seen as resilience) but it makes you stronger. The body has been primed to respond to cold with the endorphins, and immune boosting properties (once again - provided we have this holistic mindset are are being reasonable - a fine line.)
So being less dependent on coats in a trivial way - or more broadly on one's environment - is a positive thing.
5) Being Mindful
This is another matter I have realized I have just barely scratched the surface. And my knowledge of this is contained in a few things: Wikipedia entry, random articles, and correspondence with Terry Laughlin, founder of Total Immersion.
From Wiki: Mindfulness as a psychological concept is the focusing of attention and awareness, based on the concept of mindfulness in Buddhist meditation.
Terry Laughlin - a decorated swimmer and legend, who has done long swims in frigid waters - had an interesting take on the matter, “fascinated by the contrast between stingingly cold on my exterior and furnace-like warmth within. Breathing through (just as in meditation) your initial few minutes of more acute sensation of cold is also critical.”
I think there might be an interesting give-and-take here with initial stress/shock from brief cold-exposure (like with an ice-cold shower), and the body's noradrenaline-induced response priming the body for a state of mindfulness. From my experience with cold-exposure, the initial shock of cold overwhelms the body's senses immediately, and the only thing you can I can think of is "this is freezing!!!". Yet, after the shock subsides, the body flips into this moment of hyper-awareness and clarity (not the least primed by the release of norepinephrine).
Anyway, more research needs to be done here. But there seems to be some interesting positive things going on here.
6) Cold Exposure as a Powerful Reminder
Sometimes when walking outside without a coat, a bone-chilling wind gust catches me off guard. Rather than eliciting sympathy for oneself, it reminds me of the many people across the world who have to live most of there lives exposed to the elements. Or I think of the people who suffered in the gulags ,or those innocent children who were sent on marches in the Holocaust across barren frozen land in absolutely horrific genocidal campaign. It's a hard image for me to shake. And well, it puts things into perspective in life. I have NOTHING to complain about in life, even when that wind gust hits me. And when you don't feel sorry for yourself then, other circumstances in life don't seem as bad (because they aren't). Gives a new appreciation for how blessed we are in life.How I got here: The Brief History
While I was on a gap year program in Israel one of my roommates (Sam F.) was reading Tim Ferriss’ Four Hour Body book. One of the things in there was cold showers and its potential benefits. For some of the reasons I spoke about earlier, it made sense. But more importantly, that year I was working out really intensely, with my body just going full-steam ahead with any challenge. (Like doing hill intervals and after running up the hills slotting in between knuckle pushups, sometimes one-armed, on pretty hot concrete.) And so cold showers (twice a day) was a nice addition into the routine. (Though I gotta admit, cold showers in Israel aren’t so cold.)
Anyway, entering my first year in college I said I would hold off on another ironman and take that mentality to the nonprofit work (Team U) - it was a big decision for me personally. Absolutely pivotal moment. And well, the next semester I would stay up to 5am 1-2 times a week working, sometimes just spinning my wheels; I remember blasting music one night at 5am, just to stay awake to read a book on social entrepreneurship marketing, thinking it would help Team U. Unsurprisingly, I started getting sick often while I was sleep deprived.
Sophomore year I tried to get a more reasonable 6-7 hours of sleep, but I felt something lacking. I was doing high intensity interval training 1-2 a week, plus the occasional regular workout when I had time. But I needed a more solid challenge. And so I thought - why not go without a jacket this winter (sophomore year)? The cold-exposure from water would probably follow through a bit into regular outdoor exposure. And it would be a nice challenge. And so it started last year, but rather informally.
This year I thought I would continue it. And for this winter I’ve basically gone with just a tshirt on all excursions 15-20 minutes and less. And wearing shorts for much of it.
What has sustained this history are the reasons discussed above.Anyway, so that’s why I’ve been into cold exposure stuff lately.
Nice quote, credited to the incredible Harriet Tubman: Every great dream begins with a dreamer. always remember, you have within you the strength, the patience, and the passion to reach for the stars to change the world.
Rock on,
Joe
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