Prof. Dr. Nevzat Tarhan, Founding Rector of Üsküdar University and psychiatrist, participated in the symposium titled "The Sector Speaks: A Holistic Approach to the Journey of Healthy Aging" organized by the Health and Insurance Managers Association (SASDER). Tarhan, who gave a presentation titled "The Personalized Nature of Healthy Living and Mental Well-being," stated that aging cannot be stopped but can be slowed down. Tarhan said that 60-70% of diseases are related to lifestyle and talked about the need to make the human brain work like an orchestra. Prof. Dr. Haydar Sur, Dean of the Faculty of Medicine at Üsküdar University, also participated in the symposium. Sur emphasized that a paradigm shift in professional understanding is essential.
The opening speech of the symposium held at the Wyndham Grand Istanbul Kalamış Marina Hotel was delivered by SASDER President Çağatay Çınar.
The session titled "What is Healthy Living and Aging? Clinical Approach," which featured Üsküdar University Founding Rector and Psychiatrist Prof. Dr. Nevzat Tarhan speaking on "The Personalized Nature of Healthy Living and Mental Well-being," was moderated by EMPHealth CEO Dr. Cengiz Gül.
Key word: Continuity!
Prof. Dr. Nevzat Tarhan talked about the brain's ability to program itself. Tarhan said, "For knowledge to turn into action, parameters need to be operated in our brain's operating system. First, there is the dimension of thought. We add the dimension of emotion to the dimension of thought. When the emotional dimension is added, it becomes a belief, like pressing the enter key on a computer, but that is not enough. If you repeat it for 6 weeks, it becomes a habit. If you repeat it for 6 months, it becomes personality. So, the critical word here is related to our persistence. If it is sustained for 6 months, epigenetic changes begin in the brain. The brain creates a permanent algorithm for it and starts working. The person does it without realizing it. Our brain has the ability to program itself. For example, if you have a flight at 4 a.m. and you say, "I'm going to get up," and you firmly believe it, you will automatically get up at 4 a.m. Our brain calibrates itself. But if you say, "Should I get up or not?" you will often miss it. Our brain programs itself; the mind writes algorithms for the brain, and the brain works accordingly. For this, logical reasoning alone is not enough; emotional reasoning is also needed, and it must be repeated constantly. There are three types of learning. One is average learning: you make a mistake, you don't make it again. The second is how smart people learn: they benefit from the experience of others. This is very important. The third is when you make a mistake, you make it again, and again, and again, and you just can't learn."
60-70% of diseases are related to lifestyle
Stating that aging cannot be stopped but can be slowed down, Prof. Dr. Tarhan said, "A person may be 90 years old but still have the same energy. Sixty to seventy percent of diseases are related to lifestyle. Eating habits, social relationships, bonds... Sixty to seventy percent is a very important figure. So, if we can prevent 60-70%, perhaps if we can change these habits, we will see a decrease in diseases 10 or 20 years later. This is important for Turkey, which has entered this aging process. The Ministry of Health also wants to develop serious policies. These should not be short-term, day-to-day policies, but medium to long-term policies. We cannot stop aging, but we can slow it down. Currently, telomere length and telomere division are being measured. They are measured again a year later. Normally, they should shorten by a certain amount of centimeters or micrometers, but yours have shortened less. Here, they are looking at how much the telomeres will grow."
Super aging is possible!
Noting that "super aging" occurs in older people who use their brains correctly, Prof. Dr. Nevzat Tarhan said, "A person is 80 years old but is incredibly intelligent, incredibly energetic, and has incredible reasoning power. Mimar Sinan also 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 here. When exposed to stress and hardship, the first type is type A people. These type A people are like sponges. They absorb everything and always become negative when talking. What is the characteristic of a sponge? It absorbs everything. These people experience a lot of stress. Because they have many negative thought patterns, they experience depressive anxieties and worries. The second type is the exact opposite. These people are not like sponges, they are like Teflon. You know Teflon pans, they don't burn themselves but they burn whatever comes into contact with them. These people only think about their own interests, their own desires, their rights, their needs, and they cause pain to those around them. They create master-slave relationships in close relationships. These people have one characteristic: they fear being ordinary. They burn whatever they touch, but once scratched, they are thrown away. Now these people experience narcissistic injury. If everything goes well, they are fine, but if they don't get what they want or if there is a problem with their health, they suddenly fall into depression. The third type is the rubber type. They stretch and return to their original shape. These individuals develop themselves. Their neuroplasticity, the neural networks in their brains, develops. I should also mention that we owe the emergence of artificial intelligence to neural networks."
“One must operate their brain like an orchestra.”
Speaking about authentic happiness, Tarhan said, "Neuropsychologically, authentic happiness is the first step to healthy living. Authentic happiness is considered pure and genuine. It doesn't equate to the word 'happiness.' Authentic happiness, as Seligman puts it, is 'being able to be happy in any environment.' That means being able to be happy even if you're in prison. It's like being a person who bears fruit and blooms flowers in all four seasons. It's someone who can live this way, who can achieve a positive emotional state and mood in any environment. Every danger has both a threat and an opportunity dimension. Negative thinkers focus on the threat dimension of the crisis. They are always on the defensive. For example, a child gets a 97 on a test, and the mother says, 'Why didn't you get 100?' Such a person cannot be relaxed and happy. By middle age, they either have a heart attack or their immune system collapses, they get cancer, atypical cells multiply. Such people cannot relax because the human brain needs to work like an orchestra. Those people cannot make their brain work like an orchestra, but if the brain is silent, if it is constantly idle, it dulls the brain because it works according to the rule of win or lose. But the brain has all these instruments, all these areas: fine motor skills, gross motor skills, language skills, social skills, spiritual skills. For example, these skills work in autistic children. What happens to a person when they exercise all these skills? Because the entire network of the brain is working, they develop a tremendous infrastructure."
“We will see the negative, but we will take precautions against it.”
Prof. Dr. Nevzat Tarhan, who points out that whichever area of the brain is invested in, that area develops, said, "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. However, we will not be overly optimistic; we will see the negative. We will see the negative, but we will take precautions against it. At the same time, we will not lose our sense of hope. There are emotions that stimulate the brain the most. These are hope, curiosity, and wonder. If a person has these three emotions—hope, curiosity, and wonder—and they are activated, motivation arises. But for motivation to occur, a person must feel a need. First is positive emotion, second is feeling a need. When they feel a need, desire awakens. The awakening of desire also motivates the person and creates motivation. They also do needs analysis, i.e., expectation management. Right now, I need these things in a year, in five years. So, I need to make a plan according to that need. For example, if a crisis is coming, these people have crisis plans. In other words, the best way to deal with a crisis is not to manage it after it has happened. Unfortunately, in our Eastern cultures, the focus is on crisis management. However, preparations are made for crises. If a person knows what to do when a crisis hits, they can handle it smoothly. They get through the crisis with minimal impact. But someone who knows nothing about the subject makes mistakes because they lack the automatic learning mechanism in their brain. The brain's expectations and personal management are important in this regard. Whatever we invest in, whatever area we invest in, that area develops."
“They have changed the core of values”
Tarhan, who stated that the capitalist system encourages pleasure and happiness, said, "Aristotle said, 'There are two kinds of happiness.' One is hedonistic happiness, pleasure happiness. Right now, the capitalist system encourages pleasure happiness. It turns out that American society is not a dopamine society. In fact, an endocrinologist has written a book about the American brain being taken over by capitalism. His name is Lustig. That is, as a dopamine society. If you like it, it's good; if you don't like it, it's bad. They changed the core of values. Everyone is chasing pleasure. Because for the system to want consumption, everyone must chase pleasure. They must shop even when they don't need to. They must spend more money and buy more even when they don't need to. It's a system that increases production through consumption. The second type of happiness is called "hedonic happiness, eudemonistic happiness." That's meaning-based happiness. In meaning-based happiness, the person needs to think about the deep, powerful meanings of what they are doing. When they think about it, they assign meaning to every event, and this meaning doesn't cause serotonin to be released suddenly in the brain, but slowly. In other words, it is released through learning. That is why antidepressants do not increase serotonin suddenly. They increase it within two or three weeks. Meaningful happiness is also necessary for serotonin happiness. Not pleasure happiness. Since this now has a neurobiological counterpart, it is experiencing a major shift. This pleasure-focused philosophy has been shaken."
Deep but meaningful social bonds are important!
Noting that modernism encourages superficial bonds, Prof. Dr. Nevzat Tarhan said, "We place self-actualization at the top of Maslow's hierarchy. Maslow changed the top of his hierarchy before his death. This was published in 2017, but the capitalist system did not publish it. In the 2017 publication, after self-actualization, self-transcendental needs were at the top of psychosocial needs. Another name for this is spiritual, moral needs. People who can transcend themselves become happy when they make others happy. And a recent Harvard study confirmed this. It is a 75-year study by Harvard. Harvard started a study among students in the 1930s. They also took about 750 people from the poor segment. They followed them for 75 years and then published their findings. They looked at who lived long, healthy, happy lives. You'd expect it to be the rich, the powerful, those in high positions, those who are flattered and applauded from all sides. But the opposite result emerged. Those with deep, strong, meaningful social bonds lived past the age of 80. Deep but meaningful social bonds are important. Modernism encourages superficial bonds. However, having deep, strong bonds is specific to close relationships and experiences. These are bonds based on trust. The stronger we keep these bonds, the greater the investment we make in ourselves."
“Information without a purpose is the trash of our brain”
Prof. Dr. Nevzat Tarhan, who mentioned that health medicine must definitely be taught in the curriculum, said, "We do not receive health medicine education. Health medicine must definitely be taught in the curriculum. There is an example of this. One of the pioneers of bypass surgery in Turkey and the world, who performed Özal's surgery, is in his 90s and has written a book titled 'How Not to Become a Heart Patient.' This book sold 3 million copies in the US. In an interview with him, they asked, 'What are your thoughts on this book? Do you have any regrets?' He replied, 'If I had my current knowledge, I would have written this book at the age of 35. I would have contributed to preventing millions of people from becoming ill.' In other words, working to avoid becoming a heart patient. We need to teach this to doctors and healthcare professionals. There are three words: "Who said it? What did they say? Why did they say it?" Without understanding these three words, the brain does not store it in its meaningful information file. So, it doesn't just stick in your head. Information without a reason is garbage for our brain. It is easily forgotten. But if there is a reason, the logical framework in the brain gains rationality. Because it gains rationality, the brain stores it in the permanent information file. It must be linked to a reason, whether it's wrong or right. In the US, they convinced doctors who initially didn't believe in smoking cessation. Later, the US achieved success regarding smoking. That's why we need to convince healthcare professionals first."
Later, during the continuation of the first session, Prof. Dr. Haydar Sur, Dean of the Faculty of Medicine at Üsküdar University, delivered a presentation titled "Approaches to Healthy Aging and Elderly Care from a Health Policy Perspective."
Prof. Dr. Haydar Sur: "A paradigm shift in our professional understanding is essential"
Prof. Dr. Haydar Sur, Dean of the Faculty of Medicine at Üsküdar University, emphasized the importance of protecting health, stating, "A paradigm shift in our professional understanding is essential. This paradigm shift must be based on protecting the essence of health, which is a gift from God to humans, and on the awareness that once it is damaged, it cannot be restored 100%. When we think about protecting health, what are our challenges today? The food industry. Right? Fructose-laden foods, chocolates, this and that. Ninety percent of advertisements are full of nutritional elements that destroy health. Whether or not there are areas for physical activity is not very important. I don't care about that. A person can do great pilates exercises at home just by leaning against a chair, a sofa, and a wall. This is not just a problem for health professionals to deal with; first and foremost, we need to be aware of this."
“The main goal is to make the individual independent”
Emphasizing that older adults should have access to healthcare services, Sur said, "Healthy aging isn't just about aging without getting sick. That exists, yes, but the main goal here is to make the individual independent. It means being able to take care of oneself without needing anyone's help and doing so without lowering one's quality of life. Maintaining this for a long time. This approach to elderly health is not just biological; most of us understand it as something biological. We need to correct this. We need to approach it from a functional and social perspective. Aging and elderly health. I read somewhere years ago that there are two dimensions to old age: biological aging and learned aging. After a certain age, at least one chronic disease is inevitable. On top of that, we don't want a second one to be added, we don't want complications to be added, we want them to maintain their independence through long-term disease management, etc. The frequency of healthcare services is unique. As this period changes, it requires changes. This is where it is very important for the elderly to always have access to healthcare services. Otherwise, if we cannot manage this, unfortunately, the others will be of no value."
Photo: Berat Yavuz