I had a lot on my mind and, according to my half-marathon training schedule, I had a six mile run to complete today. Already cognizant that running helps me to be more mindful (in a similar fashion as dancing), I laced up my running shoes and went for a run around Central Park.

I had never heard of “leaf peeping” prior to moving to New York. I had witnessed the colors of the dying leaves on the trees in Seattle and Sacramento. While the bursts of fiery hues caught my attention, the relatively few number of trees that underwent such dramatic deaths did not impress upon me how glorious the scenes can be.

Many of the trees in Central Park have already passed the peak of their color changes, though many of them still sport beautiful, crisp gowns in the chilly air: Many of the leaves glow golden yellow and a few handful of trees have leaves that blush a deep red. Most of the trees are already starting to lose their foliage; their scraggly, bare limbs are naked and reach feebly for the sky. The leaves, once luscious, plump, and green, now lay brown, tattered, and wrinkled across the lawns, such that much of the grass is now obscured with crunchy carpets of dead leaves.

To my surprise (given the cool weather—cool to me, anyway), there were many people in the park this afternoon. Many of them were taking photographs of the trees, watching the falling leaves, or walking across the leaf-strewn fields. They were leaf peeping in the city.

I only realized during my run—sometime around mile three, I think—that the last time I worked on an inpatient psychiatric consult service prior to moving to New York was about two years ago. As part of my residency, I spent several (and spaced out) one-month blocks on the consult service. I had the good fortune of working with my fellow residents—both then and now, I realized how much support they quietly offered—and I distinctly recall sharing one afternoon, “I don’t know if I could ever do this month after month after month. It’s draining.”

Fast forward: I just started my fifth month on the inpatient psychiatric consult service. And I do not currently belong to a cohort, supportive or not.

I’ve expressed my reasons for running in the past. For me, running is also a form of behavioral activation.

(Psst: What does “behavioral activation” mean?)

Behavioral activation is a fancy name for doing stuff that is rewarding to you, stuff that makes you feel better. It’s an intervention that can be used in the treatment of depression.

According to this model, people get depressed because their interactions with the environment (”environment” can mean physical space, relationships with other people, etc.) are insufficiently rewarding (or, conversely, are punished). For example, say Gertrude enjoys baking cookies. Gertrude begins a new job (new environment) and she brings in her cookies. Most of the her coworkers don’t touch them and the few that do don’t offer Gertrude any praise.

Gertrude feels bummed out.

Or, even worse, people try her cookies, but then proceed to vomit violently in front of her. They then shout obscenities about her cookies.

Baking brings joy to Gertrude and, because her cookies received such a cold reception, she no longer bakes. At the extreme, baking is the only thing that brings her joy. Depression sets in.

According to the model of behavioral activation, Gertrude could look for other ways to reward herself. Maybe she could find a new job where people appreciate her baking. Or she could find people at her job who do like her baking and bake for them exclusively. Or maybe she could try cooking something else (maybe they all like brioches, not cookies).

Regardless, people are encouraged to engage in behaviors that (1) they can do and (2) can help shape the environment so that it becomes more rewarding.

Back to running.

For most runners, I think, there is a sense of mastery, of accomplishment, upon completing a run. The endorphins are fine, to be sure, but there are also the (admittedly self-congratulatory) internal and external rewards that follow:

• “I just improved my cardiovascular health.”
• “I ran farther today than I have ever run in the past!”
• “I saw a lot of neat things during the run, things that make me grateful to be alive.”

The thing about behavioral activation is that upon mastery of one task, one is encouraged to undertake more tasks to increase reward/reduce punishment. This is the sense of, “Well, if I could do that, maybe I should try this other thing… because maybe I can do that, too.”

Maybe they are just mind games, though in psychological parlance, the term is “reframing”. Instead of, “This is going to totally suck,” try, “This is great learning opportunity!” Instead of, “But I want the extra black and white cookie,” try, “How will eating this extra cookie help me reach my weight loss goals?” You get the idea.

With those experiences that we would rather not have, we have the grand opportunity to learn about what we want and what we don’t want. I’d like to buy into the illusion that by some arbitrary age, we will know enough to avoid the displeasures in life, that we’ll have figured out how it all works. This really isn’t the case.

It’s all a process (ugh) and, though we may choose to believe that “things will be better in the future”, we don’t know that. And, often, we’re overlooking the things that are pretty good right now. It’s hard to be grateful sometimes.

I ran six miles at my fastest pace to date today. And it was fun. I felt a small smile on my face for the last mile or two of the loop. My breathing remained relaxed. I really enjoyed myself.

Surprise: The introvert likes working with other people, in a team. She also finds much joy in teaching. She’s still interested in social justice and working with the underserved. And, despite the exhortations of others, she’s still an idealist.

Anyone hiring for next summer?