Then there are jete, colle, detache, martele, legato, loure, and more, each technique with its own distinctive sound. And, of course, all of these bow techniques must be done in close coordination with the left hand as it fingers the strings. These are not skills that can be picked up in a year or two of practice. Indeed, all of the students we studied had been playing for well over a decade--the average age at which they started was eight--and they had all followed the training pattern that is standard for children today. That is, they began systematic, focused lessons very early on, visiting a music teacher usually once a week. During that weekly meeting, the student's current musical performance was evaluated by the teacher, who identified a couple of immediate goals for improvement and assigned some practice activities that a motivated student would be able to attain with solitary practice during the week before the next meeting. I needed to distract myself and at that point I didn't know how to lie anymore so I took a colleague out and told her what had just happened. She talked me out of it for the time being and I visited a psychiatrist after that. In my experience, many of the times I confided in someone about my mental health, more often than not, people could relate to what I was saying and narrated their own experiences of loneliness or the feeling of hopelessness, and also expressed how lonely it feels in those times. Many of these times, people thanked me for being vulnerable around them and said it encouraged them to open up about their own struggles. How relieving it feels when you see you're not alone! It feels like when we share our story with someone, we take on some of their strength as well to fight our battles. It's not as tiring when we don't have to fight alone. That's why if there's anything that I can advise my younger self, it is to talk. We're only as sick as our secrets, and by talking about what is bothering us, we take away its power to control us. Be it sexuality or mental health, I wish I had opened up sooner. What had she spent it on - holidays, cars, homes? No, she replied bashfully, she liked those large prawns'. <a href=''>This</a> could be understood as a trope for a luxurious lifestyle, but if the person is manic-depressive, the reference may be absolutely literal. <a href=''>Fortunes</a> can be squandered on what seem to others like idiosyncrasies. <br /><br /><a href=''>Spending</a> money that one doesn't have is such a common feature of manic states that initiatives have been launched by the finance industry to help the manic subject negotiate their way through post-episode debt. <a href=''>These</a> sprees are sometimes described as selfish, narcissistic ramarticles showing no regard for family or friends, who often have to pick up the bill afterwards. <a href=''>Yet</a> the more we listen to accounts of what has happened, the more we realize that there is a certain altruism, a sacrificial logic at play in the sprees, and indeed, a manic subject can just as well give away possessions as acquire new ones. <a href=''>Vivien</a> Leigh would have to be kept away from fancy stores like Cartier and Asprey during her episodes, yet her spending would so often involve buying gifts for the cast and crew of the productions she was acting in. <a href=''>Acquiring</a> and giving away are equated here. <a href=''>The</a> Wall Street trader John Mulheren Jr, speaking about his experience of manic-depression, described how he would put twenty thousand dollars in envelopes and hand them out to underprivileged people in the Bowery, a poor district of Manhattan. <a href=''>Insurance</a> products are standardized, and costs--at least for those services and treatments included in the basic benefits package--are controlled. <a href=''>Overall,</a> the Swiss are very satisfied with the service they receive from their system. <a href=''>The</a> dominant recurring complaint is about the high--and increasing--costs. <a href=''>There</a> are 6 challenges in the Swiss system: quality of care, regressive cost distribution, chronic care coordination, mental health services, payment reform, and data collection. <a href=''>The</a> first challenge relates to quality. <a href=''>Traditionally</a> the cantons are delegated responsibility for assuring quality of reimbursable medical services. <a href=''>However,</a> the existing lack of quality metrics and the paucity of routine and rigorous measurement as well as public disclosure of quality data are serious problems. <a href=''>Swiss</a> hospitals perform well on avoidable hospital admissions, which account for only 3. <a href=''>However,</a> Swiss hospitals have higher rates of 30-day mortality for strokes compared to peer countries, with a 16. <a href=''>Hospital</a> stays are also longer than the OECD average. <a href=''>One</a> day, while in temple, she started conversing with a gentleman from London who was in town visiting a friend. <a href=''>They</a> quickly found out they were in the same boat with regard to having lost their spouses. <a href=''>The</a> British gentleman asked if he could see her again before he left town. <a href=''>The</a> only reason I agreed was because I knew he was flying back to London soon. <br /><br /><a href=''>It</a> was safe. <a href=''>I</a> had not a thought of dating in my mind, Meranda confessed. <a href=''>They</a> became almost inseparable during his remaining time in the States and have been in contact over the phone quite often ever since. <a href=''>Although</a> his entire family and his successful business are in London, he recently purchased a condo near her home in the States. <a href=''>We've</a> decided to just see what happens, Meranda said. <a href=''>She</a> ended our conversation with, I'm happier than I ever thought I could be. <a href=''>Because</a> most students spend the same amount of time each week with the music teacher--an hour--the primary difference in practice from one student to the next lies in how much time the students devote to solitary practice. <a href=''>Among</a> serious students--such as the ones who ended up in the Berlin academy--it's not unusual for ten- and eleven-year-olds to be spending fifteen hours a week on focused practice, during which time they are following lessons designed by their teachers to develop specific techniques. <a href=''>And</a> as they get older, the serious students generally increase their amount of weekly practice time. <a href=''>One</a> of the things that differentiates violin training from training in other areas--soccer, for example, or algebra--is that the set of skills expected of a violinist is quite standardized, as are many of the instruction techniques. <a href=''>Because</a> most violin techniques are decades or even centuries old, the field has had the chance to zero in on the proper or best way to hold the violin, to move the hand during vibrato, to move the bow during spiccato, and so on. <a href=''>The</a> various techniques may not be easy to master, but a student can be shown exactly what to do and how to do it. <a href=''>All</a> this means is that the violin students at the Universitat der Kunste Berlin offered a near-perfect opportunity to test the role that motivation plays in developing expert performance and, more generally, to identify what differentiates good performers from the very best. <a href=''>GOOD</a> VERSUS BETTER VERSUS BEST <a href=''>To</a> look for these differences, we interviewed each of the thirty student violinists in our study in great detail. <a href=''>We</a> asked them about their musical histories--when they started studying music, who their teachers were, how many hours a week they spent in solitary practice at each age, what competitions they'd won, and so on. <a href=''>The</a> following are words from a Netflix special called Nanette by an Australian stand-up comedian Hannah Gadsby (who is queer as well and talks about mental health): <a href=''>I</a> just needed my story heard, my story felt and understood by individuals with minds of their own. <a href=''>Because,</a> like it or not, your story . <a href='[]=<a+href=http://></a>'>And</a> my story . <br /><br /><a href=''>I</a> just don't have the strength to take care of my story anymore. <a href='[]=<a+href=http://></a>'>I</a> don't want my story defined by anger. <a href=''>All</a> I can ask is just please help me take care of my story. <a href=''>Do</a> you know why we have the sunflowers? <a href=''>It's</a> not because Vincent van Gogh suffered. <a href=''>It's</a> because Vincent van Gogh had a brother who loved him. <a href=''>One</a> of my patients, zigzagging round London during a manic episode, heard the troubled tale of a minicab driver, and, redirecting the car to his bank, gave him his life savings there and thenout of compassion'. For Lizzie Simon, It feels so right to do something for someone, something you wish someone had done for you. <a href=''>So</a> right it's completely intoxicating. <a href=''>When</a> I opened the door, he immediately handed me a cheque, informing me that he had to dash off to meet someone so couldn't stay, but here was the fee, which, as he found too low, he had multiplied by ten. <a href=''>I</a> never saw him again, but his wife phoned not long afterwards to make sure I never cashed the cheque. <a href=''>The</a> projects undertaken by a manic person are often directly related to helping others, the righting of wrongs, or some act of protection. <a href=''>Kay</a> Redfield Jamison reports her purchase of several snakebite kits, with the idea that she had been chosen to alert the world to the proliferation of killer snakes in the San Fernando Valley. <a href=''>In</a> buying the kits, she says,I was doing all I could to protect myself and those I cared about. And Spike Milligan was celebrated for his work with charities trying to protect the world's endangered wildlife. Manic sprees always need to be explored carefully, as beyond the apparently selfish activity this altruism may be the real motor of the spending. The availability of data on the quality of services and interventions is especially poor. One problem seems to be cultural. The Swiss have a long tradition of privacy and nontransparency, symbolized in the Swiss banking system but pervading its culture. This inhibits data collection.

Another problem is the system's structure: so much is organized at the canton level, and there is no centralized data collection. Yet another barrier to the availability of data is the lack of EHRs that would make data collection from physicians more systematic and routine. Seemingly, few physicians know the value of different procedures--or the costs. Insurers hold tightly to most quality data, leaving providers to make poorly substantiated judgment calls when deciding how to treat their patients. As a physician explains, We do not have any data--none. The morals of the story are: When it's your time to go, it's your time (give or take a little with feng shui, perhaps). Be on the lookout for opportunities. If the British gent hadn't been British (just a visitor), Meranda said, she would have turned him down, cutting herself off from the universal flow. She would have passed up her chance for happiness without even knowing it. If you think feng shui has stopped working for you because something dreadful has happened, think again. Even though you cannot possibly see anything good from such a tragic event, trust that the universe can. Love is an energy. Energy is a living thing. Therefore, to live fully we all need to give love and receive love. We asked them for their opinions on how important various activities were in improving their performance--practicing alone, practicing in a group, playing alone for fun, playing in a group for fun, performing solo, performing in a group, taking lessons, giving lessons, listening to music, studying music theory, and so on. We asked them how much effort these various activities required and how much immediate pleasure they got while they were doing them. We asked them to estimate how much time they'd spent on each of these activities during the previous week. Finally, because we were interested in how much time they'd spent on practice over the years, we asked them to estimate, for each year since they'd started to practice music, how many hours per week on average they had spent in solitary practice.