Christine Carter, PhD, reads her articles

Epizody

• 
  Smaller Than a Goal, Better Than Nothing 01.10.2026 9min

  🎧 Listen on Apple Podcasts or SpotifyI love the idea of being a runner.In 75 minutes a week, I can reap the benefits of listening to uplifting music, getting out in nature, and getting morning outdoor light, all while exercising my dogs and getting enough cardio to measurably improve my health, happiness, and longevity.At times in my life, I have been a runner. I ran a marathon in my 20s and a couple of half-marathons in my 30s. In my 40s, I mostly just made spectacular plans every January and September: I’d find exciting destination races to train for, join a gym and a yoga studio, sign up for running challenges, and pick out elaborate training plans. I’d run three or four days a week for a week or two, and then nada. Zippo. Zero runs per week.Then, in 2020, I got into a real running habit. I’ve told the longer version of this story on a TED stage, so I won’t repeat it here, but suffice it to say I did it with very, very little running. When I started going to Orange Theory classes, I kept running. I sustained this exercise habit for six years, through breast cancer and many other difficult life events.Then the Orange Theory studio down the street from me closed. I tried other studios, but the classes I like are impossible to get into.So I embraced working out on my own and getting back to running outside with my dogs. I bought very heavy dumbbells and set up a home gym on our covered porch. I spent an inordinate amount of time choosing a destination race, enlisting my adult children to join me. I set up a training schedule on my Garmin watch, and when I didn’t stick to it, I used Nike Run Club. I made a running playlist. I bought a double running leash.Friends, I have done four runs in three weeks.I know what I need to do. It’s so wildly unambitious that I’m embarrassed to tell you. I just need to get dressed to run first thing in the morning, put my dogs on their double leash, put on my playlist, and walk out the door, down the driveway, and to the mailbox. That’s it.In short: How often beats how long.I know that most days, I’ll get a walk in, and once that walk is familiar, I’ll sometimes run a little. Some days I might run more, without even deciding to. But even when I don’t feel like doing more, the morning light I get while retrieving the mail and the walk back up our steep driveway are both good for me and genuinely enjoyable. It’s way better than nothing.Ambition is the thing that fails usThe mistake I make again and again is assuming that the size of my plan and the odds of my success are related: the more inspiring the goal and the more elaborate the plan, the better my results will be.Ambition and results are related, of course, but not in the direction you think.Creating a habit takes energy and focus, and we’ve only got so much of either, which is why ambitious plans produce a brilliant week and then…nothing. It takes between 18 and 254 days for a behavior to become automatic. What predicts faster adoption isn’t ambition, self-discipline, or willpower—it’s repetition.The science of smallRepetition in a consistent context drives habit formation. Not just effort, intensity, or how badly someone wants it. Doing the thing, in the same place at about the same time, again and again, has the most impact.Success is motivating. Doing what you said you’d do, even something absurdly small, builds the belief that you can do it. Failing repeatedly does the opposite; that’s a big part of why I spent my 40s making elaborate plans but not running.Small behaviors make repetition more likely. What separates an actual habit from a nice couple of weeks is whether it holds up when you’re stressed, tired, busy, or not feeling 100%.Missing a single day doesn’t meaningfully set most people back. We don’t need to be perfect here, folks. What won’t survive is a plan so ambitious that the off days outnumber the on days.Micropractices, as researcher Eli Susman calls them, are very small behaviors that have their own benefits; a tiny practice isn’t just a placeholder for a “real” one. Susman found that 20 seconds of self-compassionate touch per day (for example, by sending kindness to yourself while placing your hand on your heart) improved mental health and reduced stress compared with a placebo finger-tapping practice.Across 280,000 meditation sessions in 103 countries, how consistently people meditated predicted their mood and resilience better than how long they sat. Similarly, a meta-analysis combining the results of many studies found that the benefits of practicing breathwork for stress didn’t depend on session length. And breaking up six hours of sitting with brief bouts of walking improves energy, mood, and food cravings more than doing 30 minutes of walking all at once.In short: How often beats how long.I hate the idea of abandoning my big plans, but the truth is I am not choosing between the ambitious version of something and a tiny one. I am choosing between the tiny version and nothing.How to build your better-than-nothing planBreak the core behavior central to your habit down into something you can do in under five minutes, start to finish. Under a minute is even better. This isn’t the version that would impress your doctor or your neighbors; it’s the version you can do while exhausted, while traveling, while a little bit sick, and when you want nothing more than to stay on the couch.Then, check it for resistance. If you feel any reluctance when you imagine doing it, it isn’t small enough yet. Cut it in half. Most people need to start with a micropractice: putting on your walking shoes and stepping out the front door, doing one push-up or 30 seconds of breathing, eating a single leaf of romaine, which, for the record, contains actual fiber and actual nutrients.Do just that for a while. Resist the urge to do more. This is hard, but the moment you’re no longer willing to be unambitious is the moment you put the whole thing at risk. That’s when difficulty enters, negotiation with yourself, and the possibility of failure. Your tiny habit doesn’t depend on motivation, which is precisely what makes it survive the days when you have none.Expand only when you’re itching to, and only in absurdly small increments. Go one more minute, not 10.What you’re actually buildingEvery time you repeat a behavior, your brain physically strengthens the connections that produce it, the way feet crossing a meadow gradually wear a path. Repeat it enough, and the path becomes a groove your brain follows on its own, no willpower required. You’re carving a neural pathway for your habit, and everything you want lies downstream from that.At some point, it will become uncomfortable not to do this new behavior. You’ll do it without deciding to, without trying to. That’s the whole goal: repetition until the thing runs itself.It’s hard to abandon our grand plans and great ambitions for something embarrassingly small. But paradoxically, it is only in that tiny step that some of our grand plans are truly born.Join us! I am doing a free Zoom webinar on October 15th from 10:00-11:00am Pacific Time with Eli Susman, PhD, whose 20-second practice appears above through UC Berkeley’s Greater Good Science Center. We’ll discuss his great book Micropractice and answer your questions about building habits by starting small. Hope to see you there!ResearchHabit formation and consistency:Lally, P., et al. (2010). How are habits formed: Modeling habit formation in the real world. European Journal of Social Psychology, 40(6), 998–1009.Success, failure, and self-efficacy:Egele, V. S., et al. (2025). An empirical ranking of the importance of the sources of self-efficacy for physical activity. Health Psychology and Behavioral Medicine, 13(1), Article 2567322.Self-compassion micropractice:Susman, E. S., et al. (2024). Daily micropractice can augment single-session interventions: A randomized controlled trial of self-compassionate touch and examining their associations with habit formation in US college students. Behaviour Research and Therapy, 175, 104498.Meditation consistency over time spent:Cearns, M., & Clark, S. R. (2023). The effects of dose, practice habits, and objects of focus on digital meditation effectiveness and adherence: Longitudinal study of 280,000 digital meditation sessions across 103 countries. Journal of Medical Internet Research, 25, e43358.Breathwork and stress:Fincham, G. W., et al. (2023). Effect of breathwork on stress and mental health: A meta-analysis of randomized-controlled trials. Scientific Reports, 13, 432.Movement breaks during prolonged sitting:Bergouignan, A., et al. (2016). Effect of frequent interruptions of prolonged sitting on self-perceived levels of energy, mood, food cravings and cognitive function. International Journal of Behavioral Nutrition and Physical Activity, 13, 113.30 seconds of breathing as a micropractice:Kumar, A., & Joshi, D. (2025). Effects of mini-meditation-based breathing exercise as intervention on induced mental stress: An EEG power spectrum evidence-based study. Asian Journal of Psychiatry, 103, 104341.Photo by Daria Trofimova on Unsplash This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit newsletter.christinecarter.com
• 
  How to Disappoint People 17.09.2026 7min

  I have spent my life making a concerted effort not to disappoint others, starting with my well-meaning worrywart mama. She passed away in 2023; that same year, I went through medical menopause thanks to breast cancer. Estrogen deprivation and grief handed me a valuable membership to the “we do not care” club; I finally felt like I had permission to prioritize self-care.At first, I chalked it up to the clarity that arrives when you bury your fiercest champion and face your own mortality in a single brutal year. But there’s both a biology and a sociology to it.Estrogen amplifies the brain’s bonding chemistry, which may help explain why many women spend their reproductive years finely tuned to others’ needs. As estrogen declines in midlife, the hold that chemistry has on us may loosen.Midlife is also when the roles that demanded all that attunement start to change: kids leave the nest, parents pass away, and we have more time to focus on other things. Our behavior shifts: one of the longest-running studies of women’s lives found that women exhibit rising social dominance, assertiveness, and self-confidence in midlife.Declining estrogen also brings wrinkles, sagging skin, weight gain, and greying, thinning hair. All our lives, we’ve been appraised by how we look, and many of us have spent staggering amounts of time, money, and energy trying to measure up, whether or not we ever felt we did. In midlife, the spotlight shifts dramatically to younger women. Invisibility stings, but it’s also liberating. When nobody’s watching, we can stop performing. We can value ourselves for all the things that matter so much more than looking young, things we actually have by now: crystallized intelligence, self-compassion, relationships that have lasted decades, and a lifetime of experience.A core theme across decades of interviews with women in their 40s and 50s has been that menopause is a turning point when women describe finding their voices and giving themselves permission to take care of their own bodies and needs rather than everyone else’s. Margaret Mead is said to have had a name for it: “postmenopausal zest.” I’m telling you, I’m really feeling that.Although I formally gave up people-pleasing the way some people give up addictive substances in 2016 (see this TEDx Talk about truth-telling), before I was diagnosed with cancer, I still found it challenging to put my own needs, especially those related to food, rest, and exercise, ahead of others. But now the biological and sociological currents are running in my favor.Joining the “we do not care” clubFor most of my life, I held an unconscious belief that I should be able to do it all, meeting my own needs and everyone else’s expectations. (I am a classic eldest daughter.) When someone didn’t get what they needed or wanted from me, I felt responsible for their disappointment. I’d scramble to fix it, smooth it over, and make both my discomfort and theirs go away.What I see now is that disappointing people is simply what happens when a person tells the truth about their limits. The reality is that no matter how productive we are, how much we work smarter (and, let’s be real: longer and harder), or how fabulous our time management and prioritization are, time is a non-renewable resource. There are only ever 24 hours in a day. That’s just reality.When we disappoint people by not giving them everything they hoped for, it isn’t a failure of our generosity, character, or ability. It’s a feature of our honesty about the limits of time.So when we disappoint people by not giving them everything they hoped for, it isn’t a failure of our generosity, character, or ability. It’s a feature of our honesty about the limits of time. When we skip sleep, exercise, or meaningful work just to check something off someone else’s list, something very real in us dies. Avoiding others’ disappointment is a costly effort paid for in resentment, anxiety, and exhaustion. I believe both my mother and I paid for it with our health: she with the ovarian cancer that killed her, and me with the breast cancer I developed while raising four kids and working full-time for a startup from my mom’s hospital room.Not being able to do it all doesn’t mean that we should try to expand our capacity to do more. The core skill here is to give yourself permission to take care of yourself, even if it means disappointing others.How to give yourself permissionThere’s no single moment when we finally give ourselves permission to prioritize our own needs. It’s something we renew, quietly, over and over. Here’s how to start.1. Take inventory.Ask yourself: Am I sleeping enough to be present with the people I love? Am I moving my body enough to stay in the game? Am I feeding myself well enough to think clearly? Am I doing the things that bring me joy and fulfillment? Do I have time to relax? To see my friends and the people I love? If the answer is no anywhere, identify your core unmet needs and start thinking about what will need to give—and who will be disappointed when it does—for you to meet them.2. If you feel guilty for taking care of yourself, recognize what that means.It does not mean that you’re lazy or that you’ve done something wrong. I know you know this, but self-care isn’t selfish. Self-care is what makes it possible to keep supporting others over the long run. When you feel guilty for going to bed instead of calling your mother-in-law, or careless for exercising instead of getting to work early, that feeling isn’t information about your character. It’s a learned response running quietly in the background. Once you label it an old alarm trained on the wrong danger, it will no longer carry the same weight.3. Practice self-compassion.When self-compassion increases, guilt about prioritizing self-care tends to decrease, and healthy behaviors follow. Higher self-compassion predicts better sleep, eating, exercise, and overall health behaviors.4. Write yourself a permission slip.At Annosa Health, I help women get into new, healthy habits, and corny as it is, the first thing we do is fill out a permission slip: “I authorize myself to [fill in the blank], even if I feel like I “should” be doing something else.” It helps because it names the specific thing you keep almost doing, the one you really intend to do but never quite let yourself do. Spelling out the specific behavior AND the obstacle it will bypass — “I will do X, even when Y feels louder” — roughly doubles follow-through compared to good intentions alone.5. Start small.Practice saying no to something relatively minor: decline an optional coffee, leave a dinner party a little earlier than you feel you should, don’t respond to a text within the hour. Watch what actually happens. We tend to be wrong twice: we overestimate how disappointed other people will feel, and also how long they’ll feel it. People move on faster than we imagine.When you tell someone you can’t do something, you’re trusting them to accept the truth that you are human, living in a material world where time is limited. Their disappointment is real. You can handle it, and they can too.This is the practice. Consciously choose your own core needs and highest priorities first, rather than deferring to others’ requests or expectations. It’s what membership in the “we do not care” club actually looks like: not indifference to the people you love, but honesty about your priorities given the finite nature of time.Every Thursday, I post a research-based essay for people in the middle of life about how to live well in body, brain, and spirit. No supplement links, no 2+ hour podcast, no promise that you’ll make it to 120. If that’s the kind of well-being you’re after, subscribe.ResearchEstrogen and social bonding: Acevedo-Rodriguez, A., Mani, S. K., & Handa, R. J. (2015). Oxytocin and estrogen receptor β in the brain: An overview. Frontiers in Endocrinology, 6, 160.Personality change in midlife: Helson, R., & Moane, G. (1987). Personality change in women from college to midlife. Journal of Personality and Social Psychology, 53(1), 176–186.Helson, R., & Wink, P. (1992). Personality change in women from the early 40s to the early 50s. Psychology and Aging, 7(1), 46–55.Helson, R., Jones, C., & Kwan, V. S. Y. (2002). Personality change over 40 years of adulthood: Hierarchical linear modeling analyses of two longitudinal samples. Journal of Personality and Social Psychology, 83(3), 752–766.Bodily changes in menopause: Zouboulis, C. C., et al. (2022). Skin, hair and beyond: The impact of menopause. Climacteric, 25(5), 434–442.Viscomi, B., Muniz, M., & Sattler, S. (2025). Managing menopausal skin changes: A narrative review of skin quality changes, their aesthetic impact, and the actual role of hormone replacement therapy in improvement. Journal of Cosmetic Dermatology, 24, e70393.Crystallized intelligence: Hartshorne, J. K., & Germine, L. T. (2015). When does cognitive functioning peak? The asynchronous rise and fall of different cognitive abilities across the life span. Psychological Science, 26(4), 433–443.Self-compassion across the lifespan: Tavares, L., et al. (2026). Lifespan perspective on self-compassion: Insights from age-groups and gender comparisons. Applied Developmental Science, 30(3), 290–306.Women’s accounts of the menopause transition: Wood, K., et al. (2025). Women’s experiences and expectations during the menopause transition: A systematic qualitative narrative review. Health Promotion International, 40(1), daaf005.de Salis, I., et al. (2018). Experiencing menopause in the UK: The interrelated narratives of normality, distress, and transformation. Journal of Women & Aging, 30(6), 520–540.Morrison, L. A., et al. (2014). Voices from the Hilo Women’s Health Study: Talking story about menopause. Health Care for Women International, 35(5), 529–548.Self-compassion and self-care: Miller, C. L., & Strachan, S. M. (2020). Understanding the role of mother guilt and self-compassion in health behaviors in mothers with young children. Women & Health, 60(7), 763–775.Phillips, W. J., & Hine, D. W. (2021). Self-compassion, physical health, and health behaviour: a meta-analysis. Health Psychology Review, 15(1), 113–139.Making a specific plan: Gollwitzer, P. M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A meta-analysis of effects and processes. Advances in Experimental Social Psychology, 38, 69–119.Sheeran, P., et al. (2025). The when and how of planning: Meta-analysis of the scope and components of implementation intentions in 642 tests. European Review of Social Psychology, 36(1), 162–194.Predicting emotional reactions to future events, and why we’re often wrong about it: Wilson, T. D., & Gilbert, D. T. (2005). Affective forecasting: Knowing what to want. Current Directions in Psychological Science, 14(3), 131–134.Gilbert, D. T., et al. (1998). Immune neglect: A source of durability bias in affective forecasting. Journal of Personality and Social Psychology, 75(3), 617–638.Wilson, T. D., et al. (2000). Focalism: A source of durability bias in affective forecasting. Journal of Personality and Social Psychology, 78(5), 821–836.Photo by Spencer Plouzek on Unsplash This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit newsletter.christinecarter.com
• 
  Audio: What if the Most Powerful Drug We Have Isn't a Drug? 10.09.2026 6min

  Billy is one of my favorite people on the planet. My husband’s oldest and dearest friend; he and his daughters are family.Seven years ago, Billy had a heart attack. He was running his own business and had full custody of his two teenage girls; he was carrying an enormous amount of stress with nobody to tap out to.When my husband and I arrived at the hospital, Billy was awake and talking and was going to be fine, thank God. Given that hospital food is what it is, we offered to get him dinner.He brightened right up. Could we bring him a burger and fries?He was joking, of course, but ironically, the hospital food service delivered Billy a burger for dinner that night. This happens in hospital rooms every day, all over the country. An artery closes, a cardiologist opens it, everyone is relieved. No one is thinking that food might be part of the treatment starting right then.Three decades earlierIn 1990, a San Francisco cardiologist named Dean Ornish ran a small, strange, genuinely radical experiment. He took people with coronary artery disease and, instead of another procedure, gave them a program: a low-fat, whole-food, plant-based diet, moderate exercise, stress management, and a support group that met twice a week.When he remeasured their blockages a year later, they’d gotten smaller. Five years out, their arteries were still opening while the comparison group’s kept closing, and they’d had fewer than half as many cardiac events. None of them were on cholesterol-lowering drugs.The prescription we didn’t getWhen I was diagnosed with breast cancer, I got excellent treatment. I cannot say enough good things about my surgeon, my radiation team, my nurse navigator, and everyone who cared for me.But, like Billy, nobody handed me a prescription for how to live once my active treatment ended, or told me what might raise or lower my risk of recurrence. Nobody told me what the research says about physical activity after a cancer diagnosis, which is a lot, or what dose of it I’d need.Nobody treated my sleep, which was a disaster, as a clinical variable. Nobody asked about my stress, though I’d just lost my mother, was working full-time, and was living with my grieving father while we fixed up a new house the sellers called a “contractor’s special.” Nobody asked whether I had people to support me, or what I was eating on the days I could barely stand up. Nobody mentioned alcohol, which raises breast cancer risk even in moderation.Everything my doctors could do, they’d done. Like Billy, I walked out of a medical system into a life where the thing most likely to determine how long and how well I lived was my own behavior. I had no prescription, support or structure for that.Structure is surprisingly powerful medicineLifestyle medicine isn’t wellness, supplements, or an alternative to your doctor. It’s a board-certified medical specialty that uses behavior as treatment: nutrition, movement, sleep, stress management, social connection, and avoiding substances that hurt us. It treats both the cause and the symptom and can actually reverse disease.There are three categories of disease likely to determine how your last decades go. And in all three, lifestyle is both preventative and curative:Heart and metabolic disease. Heart disease kills more Americans than anything else, including 1 in 5 women, and Dean Ornish’s study has now been replicated many times over. We know definitively that lifestyle change can open clogged arteries. Medicare even reimburses an intensive cardiac program whose official name contains the phrase “Reversing Heart Disease.”Cancer. Across more than a hundred studies, people who move more after a cancer diagnosis live longer.Cognitive decline. In 2025, a trial put two thousand older Americans at risk for cognitive decline into a lifestyle program of exercise, diet, and cognitive challenge. Half got a structured version with frequent team meetings; half got the same information with far less support. Both groups improved, but the group with more structure, accountability, and a room full of other people doing the same thing improved more. Behavior change isn’t a knowledge problem. It’s a follow-through problem.Dose is keyTo be effective in preventing and treating disease, behaviors need doses, just as drugs do. We get a small dose of behavior change every January, and then are discouraged when it doesn’t fix us. If you started a new drug and only took it for the first week in January, would you expect it to work? When Dean Ornish used behavior changes to treat coronary artery disease, it was intensive work.If intensive lifestyle change can shrink the plaque inside our arteries, it’s worth asking what it can do for our midlife aches and pains, our exhaustion, our brain fog. Our nervous system that never powers down.That is why my coaching program, Annosa Health, prescribes behavior at a real dose, with the structure, accountability, and other people that research shows are active ingredients.Post ScriptWhen I brought my concerns about the lack of survivorship support in my breast cancer treatment to Dr. Rita Kwan-Feinberg, the Medical Director of Sutter Health’s Carol Ann Read Breast Health Center, she took them seriously.We’re now designing a clinical study together to test the Annosa Health program for breast cancer survivors, for women going through menopause, and for burned-out physicians. I’ll write about what we find here.Photo by Chris Ralston on Unsplash This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit newsletter.christinecarter.com
• 
  Audio: September is the New January 03.09.2026 9min

  5 power moves for forming a habit that sticks, none of which involve trying harder. The problem is never your discipline. I swear. The text version has a zillion links to all the research. Links to the further practices referenced are here:* If guilt is keeping you from giving yourself permission to take care of yourself, this practice can help.* If you’re worried about failing others, know that we’re reliably wrong about disappointing people, overestimating both how upset they’ll be and how long their disappointment will last. See also this post about how to disappoint others with grace.* Here’s a practice for dealing with discomfort and difficulty.* This post is about why a daily reflection builds the self-awareness we need to make changes or adopt a new habit. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit newsletter.christinecarter.com