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This Psychology Today blog post is phase five of a nine-part series called "The Vagus Nerve Survival Guide." The nine vagal maneuvers featured in each of these blog posts are designed to help you utilize your in ways that can reduce stress, , anger, egocentric bias, and inflammation by activating the "relaxation response" of your parasympathetic nervous system.

Using gutsy third person (inside your head or in a hushed tone) is something you can do anytime and anywhere to increase healthy self-distancing while optimizing your parasympathetic (vagus nerve) response. Self-distancing via third person self-talk has been found to improve heart rate variability (HRV), which is the measurement of variations within beat-to-beat intervals and is a marker for healthy vagal tone (VT).

As an example of using non-first-person pronouns during self-talk—in which you do not use pronouns such as "me" or "I" but rather use “you” or your own name—if I were facing a challenge but was on track with a target mindset and behavior, I'd give myself some positive reinforcement by saying quietly under my breath, "Keep doing what you're doing, Chris. You've got this!"

What trigger words or phrases would you say to yourself using your first name as part of a third person pep talk? This could include some tough love that helps you "flip the script" by using a possibly harsher than usual explanatory style to break a cycle of perseverative, rut-like thinking, or rumination.

As I was growing up, I learned about using third person self-talk by observing my father, who was my first tennis coach and also a neurosurgeon who used self-talk in the operating room to trigger a parasympathetic (vagal) response and maintain grace under pressure. The key to effective self-talk is to get yourself psyched up without creating a state of discombobulated overarousal. That said, self-talk is one of the most valuable tools for honing in on the homeostatic sweet spot of balancing "fight-or-flight" responses with parasympathetic vagal maneuvers.

While curating a fresh prescriptive of nine different holistic ways to engage your vagus nerve for this series, I purposely chose the word “gutsy” to describe what is anecdotally and clinically shown to be most effective self-talk for self-distancing and reducing egocentric . In this case, "gutsy" also has a double meaning of both the GI aspects of the vagus nerve and is meant to imply having chutzpah and/or using foul language or expletives when talking to yourself in the third person.

Generally speaking, self-talk that is riddled with namby-pamby Pollyannaism isn't going to strike a visceral chord or raw nerve. On the flip side, being "gutsy" in your self-talk can benefit by selectively* using expletives during third person self-talk to boost your strength and increase pain thresholds.

As I reported in a recent Psychology Today blog post, "Swearing Can Boost Your Strength and Reduce the Sensation of Pain," a May 2017 study found that using your favorite swear words can have a “pain-lessening effect.” So, when the going gets tough...using the combination of a curse word and non-first-person pronouns could be a winning formula to optimize your performance while staying even-keeled emotionally.

As I mentioned earlier, I first learned about the power of speaking to oneself in a gutsy third person from my late father, Richard Bergland, who was my tennis coach and also a well-known neurosurgeon. Although he rarely swore, my dad once confessed to me that he had a habit of saying "Don't f*ck up" to himself in the third person before every neurosurgical procedure to relieve tension and keep himself grounded. Anecdotally, this supports what Mark Twain was referring to when he famously said, "Under certain circumstances, profanity provides a relief denied even to prayer."

Later in life, when I became an ultra-endurance athlete, I adopted the habit of almost always speaking to myself using an inner- voice that relied on non-first-person pronouns and using my first and/or last name. For me, the most effective gutsy third person self-talk involves using a drill-sergeant narrative that relies on emphatically dropping the "F-Bomb."

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For example, if I was spacing out or lollygagging during a long race, I'd chastise myself by saying, "You suck, Bergland. What is your f*cking problem? Snap out of it!" Or, if I felt as if I was being personally assaulted by vicious crosswinds in the lava fields on the bike course at Hawaii Ironman or getting battered by tempest size waves during an open water swim...I might cobble together a hodgepodge of campy self-talk lines from mavericks such as Joan Crawford or Madonna and curse at the elements saying something purposely ridiculous but empowering like, "I'm the f*cking boss around here! Don't f*ck with me!! This isn't my first time at the rodeo."

For me, when I'm inside the athletic process, the juxtaposition of using insipid catch-phrases in the depths of a gritty athletic endeavor adds another dimension of self-distancing. Along this line, when it comes to adding some finesse to my self-talk quips, I follow the advice of my college classmate, Liev Schreiber, who once described his method of acting simply by saying, "I just give the scene what it needs." When it comes to self-talk, sometimes the "scene" might require sugar-coated coddling...other times the circumstances might call for haranguing yourself with a self-inflicted diatribe.

Of course, self-talk is also a valuable tool for infusing some into seemingly dire situations while adopting the mindset of an alter-ego. For the record, any type of self-deprecating trash talk that I direct at myself in the third person is always done in a tongue-in-cheek way with a self-acknowledging wink for being cheeky. I would never recommend beating yourself up with a negative inner-dialogue that actually makes you feel "less than" or disempowered.

In looking for some empirical evidence to corroborate what I've learned through trial and error about using gutsy self-talk as an athlete, I discovered the trailblazing research of using non-first-person pronouns by Ethan Kross from the University of Michigan at Ann Arbor's Emotion and Self-Control Lab.

In a 2014 review, "Self-talk as a regulatory mechanism: How you do it matters," Kross and colleagues from the University of California, Berkeley asked themselves,"Does the language people use to refer to the self during introspection influence how they think, feel, and behave under social stress?" After analyzing seven studies that explored these questions, Kross et al. concluded that using non-first-person pronouns and one's own name (rather than first-person pronouns) during introspection enhances self-distancing.

As stated earlier, in this one-stop-shop vagus nerve survival guide, my mission is to connect the dots of various (seemingly unrelated) research that supports a wide range of vagal maneuvers that can improve your parasympathetic responses as marked by improved heart rate variability (HRV).

Within the architecture of this framework, the findings by Kross et al. on using non-first-person pronouns to enhance self-distancing dovetail with the May 2017 findings by Kyle Bourassa et al. from the University of Arizona who found that "narrative expressive writing" (which used fewer first-person pronouns) was more effective at improving HRV than "heart on your sleeve" first-person expressive writing that caused a type of "self-immersion" that seemed counterproductive when someone was going through a .

In 2016, Igor Grossmann and colleagues from the Wisdom and Culture Lab at University of Waterloo published a paper, “A Heart and A Mind: Self-distancing Facilitates the Association Between Heart Rate Variability and Wise Reasoning,” which reaffirmed that vagal tone (indexed via HRV) was associated with superior and wiser reasoning.

Grossmann et al. hypothesize that adopting a self-distanced (as opposed to a self-immersed) perspective (which is achieved by both narrative expressive writing and non-first-person pronouns) is correlated with higher HRV along with the ability to overcome bias-promoting egocentric impulses.

Ideally, when facing a stressful challenge, you want to maintain a sweet spot of arousal that is energized by the sympathetic nervous system but also maintains equanimity (even-keeled ) and grace under pressure via your vagus nerve. Consciously choosing effective “state dependent” self-talk that is tailored to a specific circumstance is one way to stimulate the vagus nerve to send messages from your cerebrum to your gut to keep you calm via efferent pathways of the vagus nerve.

“Let’s not get panicky.” —Branch Rickey (Baseball Hall of Fame coach and civil rights activist)

When it comes to triggering the calming effects of the vagus nerve, one of my favorite non-first-person self-talk quotations is “Let’s not get panicky.” from Branch Rickey, who famously signed Jackie Robinson to play for the Brooklyn Dodgers in 1945. Before signing No. 42, Rickey made it very clear that: “I’m looking for a ballplayer with guts enough not to fight back.”

Rickey was looking for someone who was both a phenomenal athlete but also had civility. He needed a person with enough inner strength and self-restraint to withstand intense hostility and without being emotionally reactive. As a role model, Jackie Robinson clearly was able to keep his parasympathetic nervous system in check and maintain equanimity.

Because so few athletes actually discuss the nitty gritty details of their inner-dialogue and self-talk, I decided to bring readers inside the thinking process of preparing for a daunting sports in the first chapter of The Athlete’s Way: Sweat on the Biology of Bliss. Christopher Bergland wrote:

“My decision to do any race always starts with a certain feeling in my gut ... In the year 2000, I decided to do the Triple Ironman (7.2-mile swim, 336-mile bike, 78.6-mile run). I had done countless Ironman races by that point—and a Double Ironman. The Triple became the next challenge, another holy grail to me. Could I go that far? For me, the Triple Ironman offered the ultimate epic adventure in the sport of triathlon because you had to do three Ironman races back-to-back without stopping, and without . That made it exciting and mysterious to me. I had to try it just to see what it felt like to go that far and be that far gone. Unfortunately, the day before the big race, I began to have flu-like symptoms. I tossed and turned all night in a big puddle of sweat and woke up the morning of my first Triple Ironman feeling really bad—achy, stuffed up, congested ... I remember sitting on the sea wall near the starting line at dawn and saying to myself in a coaching, third-person voice, “The essence of life is in the struggle, Chris. You’ve lived through other things; you’ll live through this.” “But I feel like shit,” was my honest, visceral response. The Latin phrase “Dolendi modus, timendi non item.” (To suffering there is a limit; to fearing, none.) was also going through my head as part of my pep talk. I had actually never felt so bad before a race. And this was the biggest challenge of my athletic to date. As I watched the sun come up, I did my usual deep breathing techniques, listened to some of my anthems, and said my prerace mantra, “Don’t f*ck up,” about a hundred times.”

I went on to win that race, which I think had a lot to do with talking to myself in a gutsy third person and self-distanced style. The reason I’m sharing this story is that it illustrates how I stumbled on various techniques of self-distancing through trial and error and, in many cases through my father, who was my first athletic coach.

Source: Courtesy of Kay Bergland

To this day, I can still vividly hear my father’s voice on the tennis court drilling me, “Chris, think about hammering and forging the muscle in your cerebellum with every stroke.” Because my dad was a neurosurgeon, , and ace when it came to racquet sports, his coaching technique always included elements of brain science. The lessons my dad learned in the operating room about self-distancing informed his mindset playing tennis or squash, and vice versa.

My father trained for neurosurgery at Cornell Medical School under Bronson Ray, who was the proté é of Harvey Cushing (1869-1939) whom many consider the pioneer and father of modern brain surgery. Although my father never told me where he picked up his notorious "Don't f*ck up" mantra, I have a hunch it may have been part of an oral tradition passed down from these legendary neurosurgeons. (As a side note: my father and Dr. Ray played squash regularly on a court located atop New York Hospital. Their love of racket sports and athletic rivalry led to a lifetime of professional camaraderie and close personal .)

To investigate the use of self-talk in the operating room as it might be linked to sports performance, I did some research and unearthed a small study from 2005, “The Effects of Stress on Surgical Performance,” which was published in the American Journal of Surgery.

Although this study is from over a decade ago, it corroborates many of the points about self-distancing and self-talk being made recently by Ethan Kross, Kyle Bourassa, and Igor Grossmann. For this study, researchers in the UK conducted interviews with both rookies and long-time surgeons to identify various coping mechanisms used to handle hyperactive sympathetic nervous system responses and stress in the operating room.

Interestingly, the surgeons with the most experience also displayed a higher awareness of their actions and were able to describe their coping strategies with greater clarity. That being said, most emphasized that they had learned how to apply such strategies unconsciously “by using automatic pilot.” Notably, the majority of interviewees developed strategies by trial and error or by observing more senior surgeons who seemed to effectively deal with difficulties during surgeries by staying calm, cool, and collected.

Some surgeons reported, “feeling the adrenaline rush” of a sympathetic nervous system response marked by heart pounding, sweating, headache, and physical tension while performing surgery. According to the study, these "fight-or-flight" responses reduced technical performance by making surgeons "shaky, clumsy, less dexterous, and more inclined to make small mistakes during the surgery such as badly placed stitches.”

Surgeons identified that stress responses influenced cognitive performance such as their wise reasoning, judgment, and . Most surgeons had experienced situations in which they were unable to think clearly when they were stressed out. Seemingly straightforward actions could be perceived as difficult: “When it [stress] clouds your judgment . . . you feel you can’t make a decision . . . you can’t think objectively and stress combined with tiredness which often go hand in hand . . . you can’t make a decision on simple, simple things.”

Most valuably, the surgeons described in detail the process of getting back to an appropriate physical, cognitive, and emotional state. The top three physical and psychological relaxation methods they used were: (1) diaphragmatic breathing exercises; (2) self-distancing techniques; (3) self-talk. (These are all part of the nine-part vagus nerve survival guide.)

One surgeon said, “You have to be relaxed. It’s like playing football. If you are not relaxed you are not gonna play well." Many surgeons also used a "time out" count to three type of method to "stand back" while applying relaxation methods such as deep breathing or simply waiting a few seconds until their heart rate decreased.

Alternatively, some surgeons imagined what their surgical mentors' advice would be, or they observe themselves as from a third person’s "fly on the wall" perspective. One surgeon said, “Try to be a little bit ‘third person’... Ask yourself, "What would be a sensible person’s recommendation to make this operation better for me?"

The majority of surgeons applied self-talking strategies to calm down, improve their own and focus, and guide themselves along the decision-making process with logical instructions. When I was discussing these findings with a surgeon friend of mine named Paul this afternoon on the phone, he began using non-first-person references to describe avoiding becoming "panicky" during stressful surgery. i.e. “Let’s take a deep breath and think logically, Paul. What is the next step you need to do take in order to regain control of this situation? How can you improve what you're doing in this moment?"

Eustress (good stress) can help you improve performance by enhancing alertness, , focus, or efficiency of actions. However, when stress is too high and becomes distress it is detrimental to various aspects of performing surgery, athletics, and just about anything else in life.

Hopefully, the combination of anecdotal examples and empirical evidence of various ways to use gutsy self-talk to maintain a healthy "yin-yang" homeostatic balance within your nervous system and utilize your vagus nerve will be of some use to you. Please stay tuned for upcoming blog posts in this Vagus Nerve Survival Guide series.

*Overusing vulgar language has been found to reduce the analgesic power of swear words.