Outlive by Peter Attia MD and me

I just finished Outlive by Peter Attia MD that remains on the NYT nonfiction bestseller list. It is THE best book I’ve read on healthy aging, to increase not just lifespan but healthspan – the hopefully healthy prolongation of life. I’m not going to recap in detail but he does a superlative job of discussing the deep but intertwined roots of metabolic/obesity, heart disease, cancer and neurogenerative diseases and lifestyle approaches to addressing them through exercise, stability and balance, nutritional biochemistry (diet), sleep, and emotional health.

What I really wanted to share are direct quotes from his last chapter on Emotional Health that resonated with and spoke directly to me.

Why live longer?

‘I was doing everything to live longer, despite being completely miserable emotionally.… The words of my therapist: “why would you want to live longer if you were so unhappy?’

Childhood trauma and downstream consequences

Childhood trauma generally falls into five categories: 1) abuse, 2) neglect, 3) abandonment, 4) enmeshment, and 5) witnessing tragic events. Little trauma is more challenging to address because we are more inclined to dismiss it.’

The most important thing about childhood trauma is not the event itself, but the way the child adapts to it. Children are remarkably resilient, and older children become adaptive children. The problems begin with these adaptive children, grow up to become maladaptive, dysfunctional adults. This dysfunction is represented by four branches of the trauma tree: 1) addiction (alcohol even to socially acceptable things such as work, exercise and perfectionism, 2) codependency, 3) habituated survival strategies practice (propensity to rage), and 4) attachment disorders with difficulty forming meaningful relationships.

Describing himself, “90% of male rage is helplessness masquerading as frustration. End of quote.

As his own therapist Terrance Real had had written in I Don’t Want to Talk About it: “Family pathology roles from generation to generation like a fire in the woods, taking down everything in its path until one person, in one generation, has the courage to turn and face the flames. That person brings peace to his ancestors and spares the children that follow.“

How do I want to be remembered?

In David Brooks book The Road to Character, he makes the key distinction between “résumé virtues”, meeting the accomplishments that we list on our CV, our degrees and our fellowships and jobs, versus “eulogy virtues,” the things that our friends and family will say about us when we are gone. And it shook me.” “For my entire life I, I had been accumulating mostly résumé virtues. I have plenty of those, but I had also recently attended a funeral for a woman about my age who died of cancer, and I was struck by how lovingly and movingly her family has spoken about her – with hardly a mention of her impressive, professional or educational success. What mattered to them was the person she had been and the things she had done for others, most of all her children. Would anyone be speaking that way about me when it was my turn in the casket? I doubted it. And I decided that that had to change.”

My own worst enemy

“It was as if I had my own personal Bobby Knight, the Indiana University basketball coach, who is famed for his red-faced sideline meltdowns (and who ultimately lost his job because of them), living inside my head. Whenever I made a mistake or felt I perform poorly, even in tiny ways, my old personal Coach Knight jumped up from the bench to scream at me ‘don’t you know how to grill a F**ING steak?”

“All that I had become – good and bad – was in response to what I have experienced. It wasn’t simply the big-T traumas, either; we are covered many, many more little-t traumas, hidden in the cracks, that had affected me even more profoundly. I haven’t felt protected or safe. My trust had been broken by the people who were close to me. I felt abandoned. All of that had manifested itself as my own self-loathing as an adult; I had become my own worst enemy. And I haven’t deserved any of it. This was the key insight. That little, sweet boy, did not deserve any of it. And he was still with me.”

Buddha: “your worst enemy cannot harm you as much as your own unguarded thoughts.”

Shakespeare’s Hamlet: “There is nothing either good or bad, but thinking makes it so.”

Hope

“As I settled into the next phase of my recovery, I begin to notice something I have never experienced before: I found more joy in being than in doing. For the first time in my life, I felt I could be a good father. I could be a good husband I could be a good person. After all, this is the whole point of living, and the whole point of outliving.”

Paulo Coehlo: “Maybe the journey isn’t so much about becoming anything, maybe it’s about unbecoming everything’s that isn’t really you, so you can be who you were meant to be in the first place.”

My personal footnote. Peter Attia’s final chapter was not what I had expected to end the book on the science of longevity, but it hit home. It explained with self clarity that my driven, workaholic, achievement-oriented career-long approach originated deep within my educated, yet dysfunctional family upbringing and subsequent little-t traumas, related to physical appearance and race. And except for the grace and wisdom of Steve, my best friend, and Mémée and Ray, my mentors, and most of all Teri, and the help of counselors, I would not have emerged as the better person I have become today.