Rx 11 Self Efficacy: the Antidote to Hopelessness

Please scroll below for translation of this prescription and for more information about self-efficacy and the children’s story.

Even if you’re not familiar with the classic American children’s story The Little Engine That Could, which illustrates the concept of self-efficacy, the message of the book is universally relevant. Research from around the world proves the importance of self-efficacy in helping people effectively manage their lives and overcome obstacles.
If you’re interested in seeing the book and hearing the original story, here is a link on YouTube.

Translation of Prescription
Rx When you feel hopeless, say to yourself what the little engine in the children’s story said to itself over and over again, as it worked hard to reach its goal: “I think I can…I think I can…”

This illustrates a concept called self-efficacy. It is the belief that you have in your ability to do something, even when it is difficult. Repeat this to yourself and defeat hopelessness. Research shows this is the most important predictor of success. It is your antidote to hopelessness. If you think you can, it is very like that you will!

Rx 10 Each Time You Feel Frustrated, Irritated or Upset – Brush Your Mind

Thank you for sharing this widely, especially during this stressful time.
Please scroll down for translation.

For more details about how to brush your mind please see Rx 9

Rx Each Time You Feel Frustrated, Irritated, or Upset – Brush Your Mind

  • Breathe from your belly slowly
  • Move – dance, walk, clean your house or any other constructive activity
  • Sing or chant
  • Connect with a friend or loved one
  • Remind yourself of what is going well, even when life is not perfect

Rx 9 To Be At Your Best Emotionally – Brush Your Mind

Please share this so we can get everyone engaging in mental hygiene regularly, in the same way many millions of people practice oral hygiene. Thank you!
Please scroll below for translation of text in the image.

Rx Do for your mind as you do for your teeth everyday: Brush Your Mind Everyday

  • Breathe with your belly and exhale slowly
  • Move your body – dance, walk or anything positive
  • Sing or chant – even if you think you can’t
  • Connect with a friend or loved one – via phone call, text, email or video, even if you cannot meet in person
  • Remind yourself of what is going well, even if your life is not as you would like it to be.

Rx 8 Guided Meditation Video: Access Your Inner Peace Quickly and Easily 6 minutes

Peace is always within you and this guided meditation shows you how you can be in touch with it as often as needed. You can use this as part of your daily routine or you can also use as needed when feeling tense or overwhelmed. In other words, you can use this video to brush your mind as needed.

You can follow the video with your eyes closed, or if you prefer to relax with your eyes open, you can enjoy the progression of the lotus flowers. I chose this flower because of what it symbolizes. The lotus flower grows in the mud and muck yet rises above that and offers beauty.

You can think of this as a symbol for your life, in that one part of your life is grounded in various daily realities (including the daily grind…) but you always have another part of you and another aspect of your life that transcends the daily reality, and offers you access to uplifts, beauty, meaning, and if you are so inclined, the sacred. It is a reminder that our lives can be lived on two planes and there is more to life than just the difficulties, hassles, and yes even the COVID-19 pandemic.

Rx 7 Emotional Coping with COVID-19 Video 2:40 minutes in length

This short video explains how you can brush your mind to help you more effectively manage negative emotions. Make this a part of your daily mental hygiene routine and brush your mind more often when you find yourself in difficult circumstances. (Please note, I have close captioned this in English and just added subtitles in German, French, Italian, Spanish, Polish, Hindi, Korean, Chinese and Portuguese. You can access them via clicking the setting on the video. The Chinese and Portuguese did not come out perfectly…and I am working to have those re-done, but there should still be enough to get you started. Thanks for your patience.)

Please share so we can get everyone brushing their minds.

Let’s Get Everyone Brushing…Their Minds!

By SD Shanti, March, 2014. Invited blog post for the Public Interest Directorate of the American Psychological Association. Presented here in full text to facilitate translation.

What do you get when you mix a pediatric dentist with a clinical psychologist, and toss in a master’s degree in public health?

Someone who wants to get the whole world brushing – brushing their teeth, and their minds!

Let’s face it. Preventing depression and violence is a hard sell, even harder than preventing dental caries.

Sure, we have lots of data from experts informing us about the extent of these problems, and we even have research-based information on how to prevent them. We know we can often prevent depression and violence, but why haven’t our efforts taken hold?

What I discovered in the course of my public health journey is that most people are not interested in these issues – even though they affect millions of people around the world. Among those who are interested, many are discouraged or unclear about what to do.

I believe, however, that the “Brush Your Mind” concept just might be a useful way forward.

Where we are Today

I admire and respect the late George Albee, Howard Markman, and Ricardo Muñoz for their work in prevention science. Although they’re world-renowned experts in their fields, their work has yet to be integrated into the mainstream, the way it deserves to be.

Howard Markman has had best-selling books and he’s even been on Oprah. But some years ago when I asked him about the extent to which his work had diffused within society, he responded “a drop in the bucket.”

Unfortunately, he’s right!

What will be Psychology’s Space Program?

Various fields have broken barriers and reached milestones, resulting in a collective shift of imagination. For aviation, it was defying gravity, reaching the moon and going beyond. What might it be for psychology?

I propose that for psychology, the public first needs to know and believe that it is possible to prevent or reduce psychological distress – because people cannot desire something that they don’t even know exists.  Then we will be poised to vaccinate (metaphorically) our world against violence and depression – two of the most widespread public health issues of our time.

The behavioral sciences offer us the psychological equivalent of vaccines. These include programs that can prevent violence and depression.  Just as vaccines don’t prevent all illnesses, these “psychological vaccines” cannot prevent all problems. Nevertheless, when used in a systematic and ongoing way, they will yield the following benefits to millions of people:

  • Improve quality of life
  • Reduce health care costs
  • Reduce the incidence of depression and violence.

Challenges in Translating and Communicating Psychological Research

One of the challenges in improving health through the translation of psychology is that we have a plethora of theories.  If we dig around enough in the literature, we find that they all, in some way or another, account for some degree of change.

While this may be a researcher’s dream, it’s also a translator’s nightmare.

Additionally, we’re flooded by masses of data informing us about complex problems with multi-factorial etiologies. This makes it difficult to create tidy sound bites – which are frequently the most that an oversaturated and time-starved public can realistically take in.

What we need is a means of addressing problems in a way that is simple, without being simplistic; and we need to do so in a way that promotes hope and self-efficacy on the part of the public.

Lessons from Preventive Dentistry

During my search for doctoral programs in psychology, I came across George Albee’s question “What is the mental health equivalent of fluoride?” It was a critical question that strongly influenced my approach to psychology.

In 2002, I immersed myself into the world of depression prevention and violence prevention. The various approaches to understanding behavior were intellectually interesting – but equally frustrating. It was difficult to find clarity and consensus.

In 2005, while leading an international nonprofit organization focused on violence and depression prevention, I attended a program for nonprofit leaders at Stanford. I heard Robert Sutton talk about innovation – and how one way to innovate is to look at advances in one field, and transfer those processes to another.

Sutton’s words empowered me to go to the next level – to go beyond fluoride and look for additional lessons within preventive dentistry that could advance the field of mental health.

Metaphors for Self-Regulation

I began with the widely-known phrase “mental floss,” to symbolize self-regulation – a construct common to the prevention of depression and violence. But in 2007, I discovered that term was copyrighted by a magazine. After having incubated “mental floss” in my head for some years, I was disappointed and frustrated.

During that time, I was a Visiting Scholar at Stanford University, where Albert Bandura and Philip Zimbardo were my sponsors. My time with them amounted to “marinating my brain” as I deepened my search for cost-effective public health methods to address the global problems of depression and violence.

Now I must confess that I don’t always floss my teeth everyday. I floss often and see its value. But each time I floss, it’s effortful, not automatic like brushing my teeth. My patients brushed daily, even when they didn’t floss regularly. And brushing one’s teeth is much more of a universal activity, as more people in the world brush their teeth than ever floss.

From these insights, I realized that it was no great loss to let go of “mental floss.” Even more important than flossing is brushing – and out of that I arrived at “Brush Your Mind.” And the act of brushing one’s mind meshed harmoniously with Albert Bandura’s writings on agency and self-regulation.

A Weird Idea that Works

Sometimes talking about “Brush Your Mind” was like a flash back to my high school nerd moments, when I spoke out about propellants in underarm sprays that harmed the environment. People were amused – but no one cared enough to let their under-arms stink or even switch to a roll-on.  Now, here I was a grown-up talking about a goofy sounding concept to promote mental health and sometimes I got the same looks I got in high school.

So, I took solace in three things:

  • Pediatric dentistry gave me poetic license to use humor and silliness – because they are as essential to our profession as drills and needles.
  • Robert Sutton’s book, Weird Ideas that Work, gave me hope that “Brush Your Mind” just might be one of those weird ideas that work.
  • And most importantly, although other people ridiculed me, Albert Bandura and Philip Zimbardo never did. They took my ideas and idealism seriously.

After my time at Stanford, I continued R & D on my own, working out details of the mental toothbrush. In 2013, I produced an animation video of Brush Your Mind and showed it to Samuel Dworkin (also a dentist-psychologist at the University of Washington), and Donald Meichenbaum.

My peer-reviewed video received two thumbs up.

Post publication author’s note: In addition to these two colleagues above, this video has been reviewed by other psychologists and mental health professionals.

Emboldened, I submitted an editorial on this topic to the Arizona Republic.  The responses I received from the Editor, mental health professionals, and lay readers (from the US, Canada, Europe, Asia and Australia) were gratifying.

Now I know.

As strange as “Brush Your Mind” might sound, it’s a sound idea after all!

Going Global to Reach the Tipping Point

The next step is to launch a public health campaign to promote the world-wide adoption of “Brush Your Mind.” For that, I continue to draw upon lessons from Robert Sutton, Philip Zimbardo, and Albert Bandura:

  • From Sutton: The lateral transfer of successTranslation: Roll out “Brush Your Mind,” modeled after “Brush Day and Night” – a global public-private partnership that extended to over 25 countries, and which I co-lead in 2010 when I was Head of Public Health at the World Dental Federation in Geneva.
  • From Zimbardo: Keep your messages clear, focused and easily understandable.Translation: Stay true to science, and make the content practical and accessible – even to children and adults of varying literacy levels.
  • From Bandura: Promote self-efficacy, model the desired behavior, and lots more…Translation: Join me and find out!

If we, as humans, can be so creative and ingenious as to explore the farthest reaches of outer space, surely we can make life here on Earth better for everyone. It doesn’t call for rocket science – we can do it with behavioral science.

What if We Brushed Our Minds Like We Brush Our Teeth?

Op-Ed piece by SD Shanti, originally published in the Arizona Republic, the leading newspaper of Phoenix and neighbouring region. February 2, 2014

The text of the entire article is placed here to facilitate translation.

Professor: Self-regulating behavior can make us healthier

When I graduated from dental school, I went to dental conferences and got free toothbrushes. When I graduated from a master’s-degree program in public health, I went to public health conferences and got free condoms. When I graduated from a doctoral program in psychology, I went to psychology conferences and got … nothing.

This story illustrates one of the biggest problems we face in the arena of mental health, namely that the issues we deal with are often intangible. Pharmaceuticals and caricatures of shrinks as portrayed in mass media offer us an incomplete picture of the world of mental health. What is missing is a means of describing mental-health promotion in such a way that speaks to broad audiences, from children to seniors across all countries and cultures.

Interpersonal violence and emotional distress and depression are widespread public health problems around the world, on the same scale as HIV/AIDS and dental decay. But their origins are predominantly behavioral.

There are no bacteria to vaccinate against, no viruses to vanquish, and there are no commercial products that drive an industry that supports disease prevention such as we have with toothbrushes and toothpaste.

According to the World Health Organization, violence affects one out of every three women. But violence is not only a women’s problem, as large numbers of men also experience it. Depression is a major cause of disability in the world — leading to lost productivity, distressed families and increased risk of suicide. Often, violence and depression go hand in hand.

We have seat belts and vaccines to prevent injuries and illnesses. Similarly, there exists within psychology the means of reducing, if not entirely preventing, violence and depression. However, the preventive methods are behavioral. They are intangible, yet their effects can be felt in terms of the emotions we experience and in our quality of life.

It is daunting to think about tackling these problems, especially when they affect millions of people. It’s like trying to cross the Alps on foot. But, as with any mountain climb, it all boils down to taking small and regular steps. One by one, they add up into something big and measurable.

Small steps, big progress

Self-regulation is one of those steps that will go a long way toward preventing violence and depression. If behaviors were vaccines, this would be one of them. Self-regulation is also at the heart of the folk saying: “You can’t control which way the wind blows, but you can adjust your sails.”

It can be broken down into two major realms: regulation of our actions and regulation of our thoughts and emotions. You can think of self-regulation as a psychological thermostat that keeps people from exploding in anger or spiraling into despair.

Consider road rage. Instead of reacting with irritation and aggression, if a person learns to use self-regulation in a preventive manner, he can think his way through the situation. Maybe the driver who cut him off did not mean to do so intentionally. What if he had an ailing relative he was rushing to see? Broadening one’s perspective and looking for alternate explanations of events is one way of diffusing negative emotions.

Mindfulness — the act of focusing on the present moment and letting extraneous thoughts fall by the wayside — is another means of self-regulation. It is a way of decluttering our minds, allowing us to turn off unwanted thoughts, especially those that undermine our confidence or fuel our fears.

Seeking emotional support is another way of dealing with negative emotions. Instead of withdrawing into isolation or seeking solace through chemical substances, we can turn to a trusted person such as a spouse, partner or friend.

Our bodies and minds are intricately interconnected. Exercise or any form of physical movement can also serve as an effective means of dealing with negative emotions, as anyone who has played a game of hoops to let off steam can attest.

There’s no doubt that self-regulation is important for our physical and emotional well-being. But the challenge lies in getting this concept across to a range of people of different ages, cultures and customs.

That’s where the power of metaphor comes in.

Brushing your mind

Toothbrushing is among the world’s most widely carried out acts of self-regulation. Nearly everyone does it, regardless of where the person lives or what language the person speak. What might happen if we all “brushed our minds” in the same way that we brush our teeth?

Negative emotions are a lot like dental plaque. No one escapes either; they are an inevitable part of life. In both instances, a little bit of plaque and a little burst of negative emotion are not likely to lead to serious problems. However, when left unchecked, both negative emotions and dental plaque can have a cumulative effect that will cause damage over time.

What if people learned from childhood onward how to brush their minds, just as we learn from a young age to brush our teeth?

Every health-care provider has his or her personal list of patient interactions that we never forget. One of mine was in Switzerland, where in my psychology practice, a woman sat on my sofa, Kleenex box at hand, upset and crying because of difficulties in her life. That was when it hit me, that what I was witnessing was the psychological equivalent of a toothache.

Certainly brushing one’s teeth is not a guarantee against developing a toothache. But it is definitely an important component of disease prevention and health promotion. Similarly, brushing one’s mind is not a guarantee against aggressive outbursts or sadness that impedes a person’s ability to function. But if we are to do something about the data mountains, and attempt to reduce these global statistics, we have got to start somewhere.

The formula for preventing psychological problems is similar to that of preventing other health problems. It’s complex and is influenced by a host of factors, including socioeconomic status and access to preventive services. But one of the key elements of this process is that of the individual taking action to help him or herself.

Does toothbrushing prevent all dental problems? Certainly not. Yet if large numbers of people did not brush their teeth, what might that look like? Similarly, brushing one’s mind is not going to be the end-all to the problems of violence and depression.

Yet if large numbers of people around the world regularly brushed their minds, how might their lives be different? And if large numbers of people around the world regularly brushed their minds, what impact might that have on the global data on violence and depression?

Any Time is a Good Time to Write a Letter of Gratitude and Especially so During Isolation

If you are in isolation during the COVID-19 crisis, you might consider taking some time to write one or more letters of gratitude. It’s easy to see all the things that are not working. But despite that, what is still functioning?

Who are the people in your life that matter? You can use the time of isolation to look back at persons who made a difference or are still making a difference in your life. I encourage you to write them a letter of gratitude. It is a good way to make use of your time. And it is a good way to engage in meaningful activities that help keep you emotionally healthy especially during stressful times.

If you have children, you can also do this activity with them.

If you have time on your hands or are looking for something to do with your children, you should definitely consider writing one more more letters of gratitude to the people who have made a difference in your life.

The short video below will help you get started on writing such a letter if you are unsure. I am working to make February 18 Write a Letter of Gratitude Day around the world. I chose this date to honor Chris Peterson, a psychologist who was a colleague of mine. He was a pioneer researcher and scholar in the field of modern positive psychology.
However, as you will see in the video you can write such a letter any time but do it at least once a year on what would have been his birthday.

Use the Mind-Body Connection to Your Advantage

by S.D. Shanti, PhD.
Originally published September 2001 at HealthAndAge.com. Updated and modified March 2020


Ancient cultures and philosophers made reference to the mind-body connection long ago. Now modern research confirms that this connection indeed exists. One place where this connection is strong is the relationship between your emotions and the production of stress hormones such as cortisol and epinephrine (also called adrenaline).

When people experience heightened emotions due to stress they produce more stress hormones. Frequent or lasting stress and feelings of upset translate into more hormones being secreted. These in turn contribute to increased wear and tear on your heart and a decrease in your immune system’s ability to respond and protect you from bacteria and viruses. It also can contribute to increased risk of anger or aggression.

Stress, Emotions and Health

While stress and negative emotions are two different entities, they are often intertwined. Sometimes, stress can trigger negative emotions. Other times, negative emotions such as anxiety and worry may cause a person to behave in ways that generate even more stress for themselves.

Stress in and of itself is not bad, and a little bit of it helps us to improve our performance. But when stress becomes too much or prolonged, it is harmful.

Likewise, everyone experiences negative emotions from time to time. In small amounts these are not harmful to health. But when negative emotions become part of an on-going way of responding to situations, the risk of illness increases.

Research shows that an excess of anger and anxiety (along with variations of anxiety such as excessive worry), can be harmful to your heart. These emotions increase your physiological responses to situations; and in turn, this creates an added burden for your heart. Too much stress is also associated with an increased risk of depression.

Being proactive against your negative emotions will help you achieve two things:

  • You will reduce the risk of harmful consequences of stress upon your body and upon your interactions with other people;
  • You will have a clearer mind that allows you to respond in the best way possible.

Understanding Negative Emotions

Emotions are made up of two components: thoughts and your bodily reactions. How you view a situation will affect how you will react to it.

If you are feeling scared, worried or anxious, chances are that you are expecting something bad to happen. If you feel angry, it is likely that, underneath your anger, there is a feeling that you have been wronged or that the situation is unjust.

When you feel such emotions, it is likely that your breathing and heart rate become faster than normal. The muscles in your shoulders, arms and back may become tense. You may experience unpleasant feelings in your stomach.

Stop Negative Emotional Reactions

You can reduce the intensity of your emotional response to a situation by looking for the underlying assumptions or thoughts. If you are worried, ask yourself “What are you worried about?”, and “Why are you worried?” Perhaps you fear a “worst possible outcome,” when in fact, it is not likely to happen.

If you feel angry, try to understand why you are upset. Look at your thoughts that underlie your anger. Many times people feel angry when they think that someone has deliberately hurt them or offended them.

Find an Alternate Perspective

If you are angry, worried or upset, challenge yourself to find a different perspective or explanation that can reduce the intensity of your emotions.

When someone is unpleasant towards you, you can tell yourself that maybe they are having a bad day. Looking for alternate explanations that are not personal can help to defuse your anger or other negative feelings.

When situations and people upset you, try to see things in terms of the big picture. Most likely your entire happiness does not depend upon one situation or one person. While it is true that situations and people can make your life unpleasant and difficult at times, you can take steps to control the impact on your health and emotional well being.

What You Can do When Your Anger is Justified

Of course there are times when anger is justified. However, the problem is that when we give in to anger, it clouds our ability to see and think clearly. And when anger escalates, it also increases the risk of aggression and violence.

In such moments when you feel angry, you must remind yourself of the following phrase: “Am I controlling my anger, or is it controlling me?”

In such instances, you have to engage in self-talk that soothes your upset and calms you down. You can try phrases such as “I need to stay focused on what is most important in this moment” or “This is wrong but getting angry won’t help me to solve the problem.” You can also say things like “By calming myself, I will be much more effective in responding to whatever is making me angry.”

You can also use your body to support your efforts to defuse your anger. Breathe deeply from your belly and exhale slowly. Do this as often as you need.

You can also engage in physical activity to help blow off steam. If you are homebound and cannot go outside for a walk, then look at what you can do in the privacy of your room. For instance, can you dance or do jumping jacks? Alternatively, can you do the dishes or vacuum your home?

Constructive physical activity in response to anger is like pulling your foot off the gas pedal of a car.  You make it go slower and thereby reduce the risk of a crash. Once you do that, you will be better able to respond to the situation from a calm place.

When you calm yourself, you are more likely to respond constructively rather than in unhealthy or in ways that are potentially harmful to you and others.

When anger is justified, it makes sense to speak up or speak out in a calm and constructive way. Other times it is best to just back off and cool off because the consequences of expressing your anger in an unhealthy way will be counter-productive. If you are dealing with another angry person, then giving into your own anger will only fuel escalation and can even lead to aggression.

Lastly, never punch a pillow – or anything else – to vent your anger. It is counterproductive and in fact can increases the risk of aggression by escalating negative emotions.

Pay Attention to Your Breathing

When you find yourself angry or upset, stop and take a look at how you are breathing. Has your breathing become suddenly faster? If so, breathe more slowly and deliberately. For more information on how proper breathing can help you manage your negative emotions, please see the article “Take a deep breath… and relax.

Practice Your Skills to More Effectively Manage Your Negative Emotions

Leveraging the mind-body connection consistently to your advantage takes practice, but the results are worth the effort.

Practice consists of regularly doing focused deep breathing for periods of ten to fifteen minutes a day. If you don’t have that much time, then do what you can. Even a little bit is better than none.

Additionally, you can practice searching for alternate perspectives when you experience negative emotions.You can take examples of upsetting situations from your past and use them to practice this skill.

Review these situations without being critical of yourself.

Ask yourself if you could have avoided a misunderstanding by changing your perspective. Try to identify the thought that was underneath the anger. Then try to challenge that thought with a perspective that is less upsetting.

Start first with simple examples of past experiences. These can be situations which were annoying but not overly significant. One example is an experience you might have in a store while shopping. Then, you can build up to more significant incidences that involve your family or co-workers. Again, seek to find alternate perspectives that may could have eased a tense or upsetting moment.

Please bear in mind that these are general principles and need to be adapted to your particular situation.

If you are worried about your escalating emotions such that you may pose a physical risk to yourself or others, you must seek professional help immediately.

Try to find a mental health professional who can help you or a hot line where you can connect with resources. While you are doing so, it is important that you take regular breaks to practice deep slow breathing such that you are always brining yourself back to your calm center. For a quick reminder, here is a rapid Rx for Hope.

Seek Positive Mind-Body Synergy

When you do the above steps, you train yourself to respond in ways that reduce the likelihood of negative mind-body synergy. Instead, you increase your chances of creating a healthier, more positive mind-body synergy.

Deep belly breathing, accompanied by slow exhalation increases your feeling of calm. It also helps your body by reducing the release of excessive stress hormones.  

The faster you can switch to deep belly breathing with slow exhalation, the faster you will feel better.

You may still experience negative emotions, but you will feel them less intensely; and the less intensely you feel them, the better you can function. And the better you can function, the better you will feel about yourself, even if things are not going as you would like them to.

Why Practice?

The benefits of practice include less stress, anxiety or anger in response to upsetting situations. Remember, anger, anxiety and worry interfere with your sense of wellbeing. They are a waste of your energy and will leave you feeling drained. More important, too frequent and too intense negative emotions will harm your health.

Lastly, ask yourself whether it is better to invest a bit of time now and reap the long-term benefits of good health, rather than getting sick or damaging relationships that you value.


Pay attention to your thoughts! Find alternate perspectives and slow down your breathing whenever you are upset. Engage in healthy and constructive physical activity. Doing so, will turn the mind-body connection to your advantage, even in exceptionally difficult circumstances.