President of Üsküdar University, Psychiatrist Prof. Nevzat Tarhan, attended the symposium organized by the Health and Insurance Managers Association (SASDER) titled “The Sector Speaks: A Holistic Approach to the Journey of Healthy Aging.” Delivering a presentation under the theme “The Personalized Nature of Healthy Living and Mental Adaptation,” Tarhan emphasized that aging cannot be stopped, but it can be slowed down. He noted that 60–70% of diseases are lifestyle-related and stressed the importance of managing the brain like an orchestra. The symposium also hosted Prof. Haydar Sur, Dean of the Faculty of Medicine at Üsküdar University, who underlined the necessity of a paradigm shift in professional practice.
The opening speech of the symposium, held at Wyndham Grand Istanbul Kalamış Marina Hotel, was delivered by SASDER President Çağatay Çınar.
The session titled “What Is Healthy Living and Aging? A Clinical Approach”, which included Prof. Nevzat Tarhan’s presentation on “The Personalized Nature of Healthy Living and Mental Adaptation”, was moderated by Dr. Cengiz Gül, CEO of EMPHealth.
The key word: Continuity!
Prof. Nevzat Tarhan highlighted the brain’s ability to self-program. Tarhan explained: For knowledge to turn into action, certain parameters must operate in the brain’s working system. First, there is the thought dimension. Then we add the emotional dimension. When emotion is added, it transforms into belief, like pressing the enter key on a computer, but that alone is not enough. If you repeat it for six weeks, it becomes a habit. If you repeat it for six months, it becomes part of your personality. So, the critical word here is continuity. If it continues for six months, epigenetic changes begin in the brain. The brain creates a permanent algorithm and starts working with it. The person does it automatically without even realizing it. For example, if someone has a flight at 4 a.m. and tells themselves they must wake up at that time, and truly believes it, they automatically wake up at 4 a.m. The brain calibrates itself. But if they hesitate, ‘Should I get up or not?’, they often miss it. The brain programs itself, the mind writes the algorithm, and the brain works accordingly. This is why logical reasoning alone is not enough, and emotional reasoning is needed, along with continuous repetition. There are three types of learning: the average person learns after making a mistake once and not repeating it. Smart people learn from the experiences of others, and this is extremely important. And then there are those who keep making the same mistake over and over again without ever learning.”
60–70% of diseases are lifestyle-related
Emphasizing that aging cannot be stopped but can be slowed down, Prof. Tarhan stated: “A person may be 90 years old but still continues with the same energy. Sixty to seventy percent of diseases are lifestyle-related, such as, dietary habits, social relationships, connections. That percentage is very significant. If we can prevent or change those habits, 10 to 20 years from now we may see a reduction in disease prevalence. This is particularly important for Türkiye, which is now entering an aging process. The Ministry of Health also wants to develop serious policies, and not short-term, stopgap measures, but medium- and long-term strategies. We cannot stop aging, but we can slow it down. Right now, telomere lifespan and telomere shortening are being measured. A year later, they measure again. Normally, telomeres should shorten by a certain length or microns, but in some cases, they shorten less. Therefore, the focus is on how much telomeres shrink over time.”
Super-aging is possible!
Prof. Nevzat Tarhan noted that in older individuals who use their brains correctly, a condition called “super-aging” can emerge: “A person may be 80 years old yet incredibly intelligent, full of energy, and possessing remarkable reasoning power. Even Mimar Sinan created his greatest work after the age of 80.”
“We owe the emergence of artificial intelligence to neural networks”
Emphasizing the importance of psychological resilience, Tarhan said: “There are three types of people when exposed to stress and challenges. The first are Type A people. These people are like sponges, and they absorb everything and always respond negatively when they speak. Just like sponges, they soak up everything. These individuals are highly stressed, and because they harbor many negative thought patterns, they often suffer from depressive anxieties and worries. The second group is the exact opposite. They are not like sponges but like Teflon. You know Teflon pans, while they don’t burn themselves, they burn whatever touches them. These individuals think only of their own interests, desires, rights, and needs, causing suffering to those around them. In close relationships, they engage in master–slave dynamics. They also have one key trait: they fear being ordinary. They may seem untouchable, but once they are scratched, they are discarded. These people experience narcissistic wounds. Everything may go well for a while, but when something they want, it does not happen, or when they face health problems, they suddenly fall into depression. The third group is the rubber type. They stretch and then return to their original state. These individuals develop themselves, such as, their neuroplasticity, their neural networks grow. Let me also note that the emergence of artificial intelligence owes itself to the development of neural networks.”
“The human brain must function like an orchestra”
Speaking about authentic happiness, Tarhan explained: “For healthy living, the first principle neuropsychologically is authentic happiness. Authentic happiness is thought to be pure and genuine, but it goes beyond the word ‘happiness.’ As Seligman puts it: ‘The ability to be happy in any circumstance.’ In other words, even if you are in prison, you can still achieve happiness. A person should be like a tree that bears fruit in all four seasons, like flowers that bloom continuously. Such individuals can maintain positive emotions and moods in any situation. Every danger has both a threat and an opportunity dimension. Negative thinkers focus on the threat aspect of crises, and they are always on the defensive. For example, if a child scores 97 on an exam, the mother says, ‘Why didn’t you get 100?’ Such people can never truly be happy. By middle age, they often suffer heart attacks, weakened immune systems, cancer, or abnormal cell growth because they cannot relax. The brain must function like an orchestra, but these people cannot make their brains work that way. If the brain is left idle or over-rested, it weakens because it functions on a win-or-lose principle. However, when all instruments of the brain are activated, that is, fine motor skills, gross motor skills, language skills, social skills, spiritual skills, and what happens? For example, in children with autism, these abilities are stimulated. When a person exercises all these skills, the entire brain network is engaged, and an incredible infrastructure develops.”
“We must see the negative but take precautions against it”
Prof. Nevzat Tarhan emphasized that whichever area of the brain is invested in will develop: “When an event occurs, we first divide it into negative and positive information. We will see both the negative and the positive, but we will focus on the positive. Yet we should not fall into blind optimism either, and we must acknowledge the negative. We will see the negative but also take precautions against it, while never losing our sense of hope. The emotions that most activate the brain are hope, curiosity, and wonder. If a person has these three and they are stimulated, motivation emerges. However, for motivation to exist, a person must feel a need. First comes positive emotion, second the sense of need. When a need is felt, desire awakens. When desire awakens, it drives the person to action and motivation arises. This is also where need analysis, that is, expectation management, comes into play. For example, I may say: ‘In one year, in five years, I will need these things.’ Then I must make a plan according to those needs. If a crisis is likely, these people already have crisis plans. The best way to deal with a crisis is not to manage it after it begins but to prepare for it in advance. In Eastern cultures, unfortunately, the focus is on managing crises only after they happen. But the right approach is preparation. If a person knows what to do when a crisis hits, they can respond quickly and effectively, minimizing its impact. But someone with no knowledge and no automatic learning system in their brain will make mistakes. This is why the brain’s expectations and personal management are so important. Whatever area we invest in within our brain, that area develops.”
“They changed the body of values”
Prof. Nevzat Tarhan stated that the capitalist system encourages pleasure-based happiness: “Aristotle said, ‘There are two kinds of happiness.’ One is hedonic happiness, the happiness of pleasure. The capitalist system now promotes hedonic happiness. It turned out that American society is not a dopamine society. In fact, an endocrinologist named Lustig even wrote a book on how the American brain has been captured by capitalism, which describes it as a dopamine society. If something feels good, it’s seen as right; if it does not, it ,s wrong. They changed the body of values. Everyone is chasing pleasure. Because for the system of consume–earn–consume–spend to survive, everyone must be in pursuit of pleasure. People must shop even when they do not need anything, must spend more even when unnecessary. It’s a system that increases production through consumption. The second type of happiness is eudaimonic happiness, that is, happiness of meaning. This requires a person to reflect on the deeper and stronger meanings of what they do. Because when you ascribe meaning to experiences, that meaning generates serotonin in the brain, not all at once, but slowly, over time, as you learn. That’s why antidepressants do not increase serotonin immediately, and they take two or three weeks. For serotonin-related happiness, we need meaning-based happiness, not pleasure-based happiness. Since this now has a neurobiological counterpart, the pleasure-centered philosophy has been deeply shaken.”
Deep but meaningful social bonds matter!
Prof. Nevzat Tarhan drew attention to how modernism promotes superficial connections: “In Maslow’s hierarchy of needs, we put self-actualization at the top. But before his death, Maslow changed this. In a 2017 publication (suppressed earlier by the capitalist system), it was revealed that after self-actualization, the highest psychosocial needs are self-transcendental needs, which is also called spiritual needs. People who transcend themselves become happy when they make others happy. Harvard confirmed this in its latest study, a 75-year research project. In 1938, Harvard began tracking students and also included about 750 people from poorer backgrounds. They followed them for 75 years to see who lived long, healthy, and happy lives. Contrary to expectations, it wasn’t the wealthy, the powerful, or the admired who thrived, but those with deep, strong, meaningful social bonds. They were the ones who lived past 80. Deep but meaningful social bonds matter. Modernism encourages shallow ties, but deep and strong bonds come from close relationships and lived experiences. These are bonds of trust. The stronger we keep these bonds, the greater the investment we make in ourselves.”
“Knowledge without a reason is trash for the brain”
Prof. Nevzat Tarhan emphasized that medical education must include preventive health: “We do not receive preventive health education. Preventive medicine must absolutely be taught in the curriculum. For example, one of the pioneers of bypass surgery in Türkiye, and the surgeon who operated on President Özal who wrote a book in his 90s titled How Not to Become a Heart Patient. In the U.S., this book sold 3 million copies. In an interview, they asked him, ‘Any regrets about this book?’ He replied, ‘If I had the wisdom I have now, I would have written it at 35. I could have prevented millions from becoming patients.’ This shows the importance of prevention. We must teach doctors and health workers this mindset. There are three key questions: ‘Who said it? What did they say? Why did they say it?’ Unless the brain understands the why, it does not file knowledge into the meaningful-information folder. Knowledge without a reason is trash for the brain, and it is easily forgotten. But when there is a reason, the brain integrates it rationally and stores it permanently. Right or wrong, knowledge must be connected to a reason. For instance, in the early days, many doctors didn’t believe smoking was harmful. Once they were convinced, the U.S. succeeded in its anti-smoking campaign. That’s why we must first convince healthcare professionals.”
Later in the continuation of the first session, Dean of Üsküdar University Faculty of Medicine Prof. Haydar Sur also delivered a presentation titled “Approach to Healthy Aging and Elderly Care from a Health Policy Perspective.”
Prof. Haydar Sur: “A paradigm shift in our professional understanding is essential”
Following the first session, Üsküdar University Faculty of Medicine Dean Prof. Haydar Sur delivered a presentation titled “Healthy Aging and Approaches to Elderly Care from a Health Policy Perspective.” Prof. Sur emphasized the importance of health preservation: “A paradigm shift in our professional approach is essential. This shift must move away from focusing only on illness, diagnosis, and treatment, and instead focus on preserving the precious gift of health bestowed by God, that is, understanding that once it is lost, it cannot be fully restored. What are today’s challenges in protecting health? The food industry, for one. Fructose-laden products, chocolates, and so on. 90% of advertisements promote foods that destroy health. Whether or not physical activity areas exist, it is not as crucial, and I do not stress about that. A person can do excellent Pilates at home using just a wall, a chair, and a sofa. This is not a problem healthcare professionals can solve alone, and we must all acknowledge this.”
“The main goal is to make the individual independent”
Highlighting that the elderly must have access to healthcare, Sur continued: “Healthy aging is not just about growing old without illness. The main goal is to make the individual independent, that is, being able to manage life without relying on others, without lowering their quality of life, and to sustain this as long as possible. This approach shows that elderly health is not purely biological, as many assume. We must correct this misunderstanding. It must be considered from a functional and social perspective as well. I once read that aging has two dimensions: biological aging and learned aging. After a certain age, at least one chronic illness is inevitable. The key is to prevent a second illness, avoid complications, and maintain independence through long-term disease management. As time passes, the frequency and intensity of healthcare needs change. That’s why ensuring constant access to healthcare for the elderly is crucial. Otherwise, other measures lose their value.”
Photo: Berat Yavuz