Claire Dorotik LMFT

I teach people to leverage adversity -- and use it like a springboard.


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Run South Florida Articles

Claire Dorotik M.A. 

While amateur athletes and beginner exercisers often feel as though athletes are in a completely different class, the reality is that what separates athletes from beginners most is not what they do, but what they think. Looking at all classes of athletic events from swimming to tennis, the elite performers share one thing in common. That is, hours upon hours of practice. Relatively few athletes who enjoy success at any level are truly gifted, and therefore do not have to devote the multitude of hours that others do. Instead, what makes great performers is great practicers. These are the people who live and breathe their sport. They make learning their sport their passion. Does this mean they don’t experience dips in their motivation like the rest of us? Does this mean they don’t have days where they DO NOT want to practice? Of course they do. They are human after all.  But the difference between athletes and beginners during these times is what is happening inside their head. So lets take a look at some differences between beginners and athletes: 


BEGINNERS: For a beginner, a setback is a personal definition. When most people just start an exercise program, they truly do not see themselves as successful athletes yet, so when a setback occurs, it only adds to their belief that they’re not yet an athlete. When most people don’t feel like something they don’t do it. For example, if you do not feel like an actor, you are going to have trouble performing in front of the camera.

ATHLETES:  For an athlete, setbacks go with the territory. That is, they are a given. Setbacks can mean lack of preparation, need to re-focus psychologically, or being over-matched by an opponent. But setbacks are not personal definitions. While they can indicate errors in training, focus, or play, they do not indicate who we are as people. Setbacks do not create failures out of people, people create failures out of people. 


BEGINNERS: Beginners often feel as though motivation is something that should be occurring for them. When they don’t have it, it becomes another measure of the ways that they are different from those people (athletes). For this reason, beginners often make the inaccurate conclusion that athletes are born with motivation.  Motivation is about want, and therefore does not exist in the DNA, but rather in the thought processes. However, for beginners not having want or motivation means that they must not be athletes. 

ATHLETES: Athletes understand that motivation, just like their sport is something they have to work at. It does not exist by itself, and instead, must be created. Athletes also understand the connection between identity and motivation. The more they see themselves as elite athletes, gold medal winners, national champions, etc., the more they are going to want it. Therefore, they work very hard to incorporate the best training plans, nutrition, rest and thoughts into their daily lives, so that every part of what they do moves them closer to that identity of a stellar athlete.  


BEGINNERS: The number one reason most beginners start an exercise program is to lose weight.  The exercise is then viewed as a response to over-indulgence, as sort of punishment for gluttony. The attitude toward exercise then becomes something of dislike. The exercise may be performed, but it is begrudgingly. After all, how do most of us view punishments? Further, what do we try to do with punishments? We try to avoid them.

ATHLETES: Athletes view exercise as an invaluable part of their life, without which, their identities would not be possible. Exercise is something that is coveted, and most athletes live for that “great practice, perfect swing, awesome run”, or the all important, “personal best.” The attitude toward exercise then becomes one of appreciation and gratitude. This sentiment is often extended to the surroundings, such as the “perfect court, perfect wind conditions, awesome hills to train on,” the equipment, such as the “perfectly strung racket, best feeling shoes, or perfectly tuned bike,” and the people, such as “great support crew, enthusiastic fans, or friendly competitors.” Athletes also recognize that the more they feel this gratitude, the better the exercise becomes. While most people do not have aspirations to be an elite athlete, they do want to be healthy. It is also something that most people struggle with. However, it is not that beginners can’t be athletes that they struggle, it is merely that they do not think like athletes.

Claire Dorotik M.A. 

“Are you following the program?” “Did you stay on the diet?” “In order to lose weight you have to workout at least two hours a day.”  Sound familiar? We have all heard these sentiments, or similar ones before. Especially when speaking about weight loss, we have been told too many times what to do. Surely, we have also asked too many times what to do. However, being told what to do, or following someone else’s program is one of the quickest ways to deter motivation. And without motivation, even the best intentions will not lead to weight loss.

To be sure, there are many reasons that people wanting to lose weight and the trainers wanting to help them will fall into this trap. Trainers often feel as though they are not doing their job if they don’t solve the client’s problem. On the other hand, clients often feel as though they are not succeeding at weight loss if they don’t immediately have the answers. The client may ask the trainer for advice, seeking to find the solution and avoid the uncomfortable feeling of not knowing the answer. The trainer may see this as an opportunity to help the client and offer a solution. Yet this situation is a set up for both the trainer and the client. The client has avoided the essential work of finding her own solution to her problems (the trainer will not always be there), and in addition to this, may in time begin to resent the solution as it never really was her own, but simply sounded better than anything else she had at the time.

Conversely, if the solution doesn’t work, the client is going to look to the trainer to blame. The trainer, who thought he was being helpful, is being blamed for something he is not ultimately responsible for. Not even the best trainer is ever responsible for the client’s behavior, or success at weight loss for that matter. The role of the trainer is only to provide the client with the best guidance possible, it is up to the client to evaluate that guidance and decide what will work best for her, and then take action. But if the client takes the action that the trainer recommends without evaluating it first, she has set up the trainer to be blamed when it doesn’t work. The underlying theme is that she has not taken responsibility for her own behavior.  

Here is where autonomy comes in. Autonomy is defined as personal independence and the capacity to make moral decisions and act on them. When the client becomes autonomous, she also becomes responsible for her own behavior. But inherent in this definition is the ability tochoose for herself. This choice is not something that can be compromised by the opinions, evaluations, or judgments of others. This is the difficulty many teachers, mangers, and trainers often have, accepting the person as is. She may share the same goal as the teacher, manager, or trainer, and have an entirely different way to get there. 

Trainers will often interpret this autonomy as resistance. In fact it is. However, it is resistance to not being allowed a sense of choice. In that respect, it is healthy. More importantly, as a sense of choice and autonomy are powerful components of motivation, when the client chooses to do something of her own volition, she is experiencing a rise in motivation. This is true even in the case that her choice appears to oppose her shared goal with the trainer. As we all know, there is a plethora of ways to do things, and the client may appear to not want to progress toward her goals when choosing to differ with the trainer, yet she is experiencing her own way to get to this goal. Part of this experience may be deciding what she is ready for and not ready for. It may also be overcoming her own resistance. 

More than ever, in the case of weight loss, there will be resistance. Whenever any person makes a choice to do something, it is actually a process that involves progressing through several stages. The first stage (pre-contemplation) especially involves a lot of opposition, as the person has not actually found her own reasons for making the change. Certainly, without being given autonomy to find these reasons, any change she does make will only be a surface one, and will not last. In terms of lasting change, which is what we all want, this sense of autonomy then, is indispensable.

There are actually four elements of autonomy that people can have. They are autonomy over task, time, technique, and team. Autonomy over task describes the ability to choose what we do. We can be given a general guideline, such as a manager asking employees to come up with a new design for our website, but what that design is must be something of the employees own creation. In that sense, autonomy over task allows us to be creative about the activities that we do. In terms of weight loss, it allows us to use our own imagination and resources to define how we will reach our goals. Autonomy over time describes when, and for how long we will do what we do. We, again can be given a general guideline, such as a manger giving an employee flex time in which she must complete thirty hours of work, but when she does these thirty hours is up to her. Much like autonomy over task, autonomy over time allows us to be creative about how we will progress toward our goals. Given that weight loss is not an exclusive activity and must be fit among many other life responsibilities and activities, autonomy over time is crucial. Autonomy over technique describes how we will do what we will do. While, as with the first two components, we can be given a general framework, such as being asked to paint a fence, how we paint the fence is up to us. Obviously, each person will have her own unique style, and autonomy in this division over our lives allows us to express and develop our own unique strengths. Clearly, feeling strong is something that not only promotes weight loss, but also transcends it.  Autonomy over team describes who we will do what we will do with. It is the ability to choose the people we want around us in the activities that we do. Autonomy in this area allows us to surround ourselves with people that we feel comfortable with, and with whom we feel we work best. We can determine for ourselves the ability level with which we are most motivated. Additionally, we can choose the attitudes, behaviors and actions with which we progress the furthest. While it is not the ability to pick our neighbors attributes, it is the ability to pick our neighbors. Choosing who we surround ourselves with is married to our comfort level, which in turn, greatly impacts our drive to lose weight.

Achieving lasting weight loss is not an easy process. More often than not, the perceived solutions that come in the form of manufactured and homogenized approaches are actually much of the problem. Lasting success and the happiness it brings is never pre-packaged. Instead, the first step should be finding your own way to motivation.  

Claire Dorotik M.A. 

  1. How many calories does the typical 150 pound person burn in one mile?
    1. 200
    2. 150
    3. 100
    4. 300
  1. You burn more calories by running a mile than walking it.
    1. true
    2. false
  1. Running hills expends approximately how much more calories than running on level surface?
    1. 200%
    2. 150%
    3. 125%
    4. same
  1. Pronation is known as:
    1. the inward rotation of the foot and ankle upon impact and puchoff phases of the running stride
    2. the outward rotation of the foot and ankle upon impact only
    3. the upward flexion of the foot before impact
    4. the downward flexion of the foot upon pushoff
  1. Shin splints are often a cause of
    1. excessive pronation
    2. excessive supination
    3. plantar fasciaitis
    4. weak tibialis anterior muscles
    5. A and D
  1. The average 150 runner needs to consume how much water per hour on a warm day?
    1. 2 oz
    2. 8 oz
    3. 6 oz
    4. 12 oz
  1. Which substance is absorbed from the stomach most quickly?
    1. Gatorade at 50 degrees celcius
    2. Water at 50 degrees celcius
    3. Water at 70 degrees celcius
    4. Gatorade at 70 degrees celcius
  1. Running shoes with air or gel inserted into the sole typically retain 70% of their cushion and spring for how many miles?
    1. 600-900
    2. 300-600
    3. 300-500
    4. 200-400
  1. In terms of inflammation caused by running, the majority of it occurs when?
    1. immediately following the run
    2. 6 hours after the run
    3. while sleeping the night after the run
    4. the next day
  1. Soreness caused by a long run can best be reduced by:
    1. ibuprofen
    2. icing 
    3. stretching
    4. massage

Answers: 1. C 2. B 3. C 4. A 5. E 6. C 7. B 8. C 9. A 10.B 

Claire Dorotik M.A.

Is running something you have always wanted to do, but perhaps have been hesitant to try? Maybe you have heard that running is bad for your knees. Maybe you have been told that humans are not meant to run. Or perhaps you have visions of hours of painful toiling away on a never-ending stretch of road. Well the truth is, none of those things are true about running. First of all, running is a survival mechanism, and therefore, humans are meant to do it. Secondly, running is not bad for your knees, and certainly much better than our current sedentary lifestyles for ensuring longevity. Lastly, running should be enjoyable. After all, don’t kids love to run? So if you are considering beginning a running program, there are several things that you can do to increase your enjoyment and consequently, your success. 

DO NOT CHECK YOUR WATCH: While you will want to know how long or how far you have run in order to keep track of your weekly mileage, checking your watch during a run is the surest way to decrease your enjoyment. Why? When you check your watch you remove yourself from the qualitative process of running. You forget about your form, and focus on how far or how long you have gone. The surest way to make time go slow is to focus on it. This is exactly what you do when you check your watch. In addition to this, when you stop focusing on your form, you tighten up, and the run immediately feels harder. Now not only does the run feel harder, you are focusing on it more. Instead, focus on your form intermittently, and for the rest of the time, try to RELAX and let your mind wander.

LOWER YOUR ARMS: This is one of the most common mistakes of beginner runners. The arms are held too high, too close to the chest, and the arm swing is restricted. When your arms are in this position, not only are you biomechanically compromised, but you are also compressing your lungs. As the shoulders raise and pull forward, the arm swing comes across the chest, causing the intercostals muscles between the ribs to contract unnecessarily, decreasing the ability to expand the ribcage. Additionally, the muscles of the trapezius (upper shoulders) tighten straining the neck. With a restricted arm swing, the length and propulsion of the leg swing is also restricted, reducing speed and power.  With less power, compressed lungs, and strained shoulders, it is no wonder running feels hard! Instead lower your arms, and allow your hands to swing straight past your sides as if you are wiping them off on your hips.

STAY UPRIGHT: This may sound like a rudimentary concept, however, leaning too far forward is a very common error of beginner runners. While the ideal body angle is ninety degrees, or perpendicular to the ground, most first time runners lean forward by five to ten degrees. This excessive forward lean causes several stresses on the body. Primarily, the muscles of the lower back are strained as they are absorbing more of the core weight than the abdominal muscles. To check this out on yourself, simply trying standing on your toes on leaning forward. You might notice that it doesn’t take long for your lower back to start talking to you. However, straining your lower back isn’t the only strain that occurs when you lean too far forward while running. With even a five degree forward lean, your quadriceps absorb a disproportionate amount of your weight than your hamstrings. Because your hamstrings actually have three insertion points, they are much better equipped to stabilize your knee upon landing than are your quadriceps. But when you lean forward, your quadriceps are forced to absorb the majority of the shock, placing stress on your knee, and potentially compressing your patella. The more this happens, the tighter the quadriceps muscle tend to become, and the more compressed the patella becomes. This results in a common condition called “runner’s knee.” Instead, pull your shoulders back, keep your eyes level (do not look down), and your back straight. Then pull your hips underneath you and tuck your tailbone under as well (the equivalent of a dog tucking his tail). This position will keep your back straight, and your lower back and knees free from strain.

Claire Dorotik M.A

As the weight loss advice of the day seems to be rampant with suggestions about lowering your carbohydrate intake, avoiding sugar, and keeping your blood glucose level stable, we are given several reasons why all of these suggestions are good for us.  We are told that, for example, lowering our carbohydrate intake will decrease the amount of insulin our body produces, thereby staving off any risk of insulin resistance.  Or, experts say, by keeping our sugar intake to a minimum, we are encouraging our bodies not to store the sugar, potentially leading to weight gain.  What we are not told, however, is whether or not these changes will affect us in other ways.  While all of the advice sounds good theoretically speaking, will there be any drawbacks to a very low carbohydrate diet?  Am I really going to notice if my body is producing less insulin?  Physically maybe, but what about mentally?  Is it true that blood sugar level affects the way we think?  Anecdotally, we can all attest to the fact that we get cranky when we are hungry, but is there more to this story?  To answer this question, let’s look at the most recent research. 

Alzheimers disease is widely regarded as a brain disease that is degenerative in nature, and results in a lack of orientation, poor judgment, memory impairment, and motor and language disturbances.  It is comprised of both a genetic and environmental component.  As there to date, has been little that can done to control the genetic component of this disease, much of the research has centered on the environmental contribution to the development of the disease.  Factors such as sleep, exposure to toxins, previous history of disease, and exercise, have been looked at.  Recently, however, new research that suggests a link between dangerously low blood sugar and dementia in older patients with type 2 diabetes has caused us to look at the role blood sugar levels play in not only in affecting the way we think, but also, in ensuring the health of our brains. Older patients in the study whose blood sugar fell so low that they ended up in the hospital were found to have a higher risk for dementia than patients with no history of treatment for low blood sugar, known medically as hypoglycemia. Having uncontrolled diabetes is associated with an increased risk for Alzheimer's disease and other age-related dementias in elderly patients.

Several other recent high-profile studies have raised similar concerns. Researcher Rachel Whitmer, PhD, of Kaiser Permanente Division of Research in Oakland, Calif., says understanding the impact of blood sugar on cognitive function is older patients is critical.  "We are in the midst of an epidemic of type 2 diabetes and we are going to see more dementia than we have ever seen before as these patients age," she tells WebMD. "We really have to get a handle on the role of glycemic control in this." Blood Sugar and Dementia The study included 16,667 patients with type 2 diabetes enrolled in a northern California diabetes registry. The average age of the patients at study entry was 65. Whitmer and colleagues examined more than two decades of medical records to determine whether the participants had ever been hospitalized or treated in a hospital emergency department for hypoglycemia. Symptoms of hypoglycemia can include dizziness, disorientation, fainting, and even seizures. Mild to moderate episodes often don't require treatment, but severe episodes can lead to hospitalization. None of the study participants had a diagnosis of dementia when they were enrolled in the study in 2003. Four years later, however, 1,822 of the more than 16,600 patients (11%) had been diagnosed with dementia. Compared to patients with no history of low blood sugar requiring treatment, patients with a single episode of hospital-treated hypoglycemia were found to have a 26% increase in dementia risk. Patients treated three or more times for hypoglycemia had nearly double the dementia risk of patients who had never been treated.

Clearly, studies such as this one cause us to think about the affect of blood sugar on the way we think, and the overall health of our brains.  With the influx of low-carbohydrate diets, and nutritional advice to avoid sugar, we might be sacrificing the health of our brains, for weight loss.  While certainly weight loss is an admirable goal, and needs to be encouraged, there needs to be balance,  particularly, when it comes to the way blood sugar levels affect our brains.  

Adopting a pattern of balance between carbohydrate, protein and fat is the best way to ensure appropriate protection of your brain.  While popular weight loss programs have strayed from the accepted balance of 50% carbohydrate, 30% fat, and 20% protein, by suggesting carbohydrate intakes as low as 20 grams per day, or less than 10% of total caloric intake, there are obvious health risks to this approach.  In fact, common complaints of many people who ascribe to these low carbohydrate diets include dizziness and forgetfulness, also symptoms of hypoglycemia.  Taking these symptoms, along with the recent research into consideration then, gives support to the role balance plays in nutritional intake.  Not only is balance an effective way to lose weight, as many of the participants of these low carbohydrate diets quickly regain the weight, but also an important part of protecting the health of your brain.  The study appears in this week's issue of Journal of the American Medical Association.  

Claire Dorotik M.A. 

On a primitive level, stress is helpful. It prepares us to run. It prepares us to fight off attackers. The heart rate increases, sending more oxygen rich blood to the muscles, the endocrine system shunts epinephrine and adrenaline into the system, decreasing our reaction time and increasing our mental alertness, and the muscles tense, ready to propel us in whatever direction we need to go.  However, this situation was meant to be resolved. Unfortunately, for many people, it never is.

According to a 2004 survey by The American Psychological Association, two thirds of Americans are likely to seek help for stress, and 54% are concerned about their level of stress. What these numbers mean is that stress is not a temporary thing for most people. Instead, it is a perpetual condition.  Living in a constant state of stress can have many deleterious effects. At first glance, a constantly elevated heart rate and increased blood pressure are risk factors for cardiovascular disease.

A more thorough look reveals that states of constant stress cause an endocrine response that predisposes people to food cravings. The levels of epinephrine increase, and the levels of serotonin and dopamine decrease, essentially mimicking the condition of being hungry. In the case of an actual danger, the endocrine changes would make sense, and would be helpful in averting the danger. However, when there is identifiable danger present, the changes can be detrimental. Where in the case of actual stress averting the danger will normalize the endocrine response, in the case of no danger, eating will temporarily normalize the response. Therefore, because most people experience chronic stress, not actual danger, the elevated levels of epinephrine, and decreased levels of serotonin and dopamine can often result in food cravings.

This situation has been replicated many times in studies using rats. Under induced stress conditions, such as cold temperatures or high frequency noise, the rats choose a higher fat version of food, and ate more of it. Incidentally, they gained more weight than the rats not exposed to the induced stress situations. Constant stress also reduces cognitive capacity. When the limbic system, where emotions are felt, activates, the blood flow to the prefrontal cortex, where planning and inhibition occurs, is compromised. With a reduced blood flow, the ability to foresee potential problems and plan accordingly suffers.

Additionally, the ability to inhibit ineffective responses becomes challenging. In this state, the person may not be able to think rationally and realistically, and instead is acting reflexively. Again, this is a helpful response when there is actual danger, however, when the problem requires insight and planning, this response can jeopardize the results. This tendency toward impulsivity makes avoiding food cravings increasingly difficult, and the more these cravings are given in to, the more restrictive the repertoire of responses becomes.

Over time, alternative solutions to the problem of stress become less likely. This restrictive nature of responses is indicative of the restrictive nature of thought patterns when stress hits. Due to the effect on cognitive capacity, the ability to use creativity to identify alternative, or novel, solutions to unsolved problems is jeopardized. In times such as this, the tendency is to revert to previously learned patterns. This regression is usually toward primitive, or immature, ways of managing stress.

What was once a way of managing anger as a young child, may re-emerge in adulthood if given the right amount of environmental stress. The feelings of relief that accompanied eating as a child, will again appear as an attractive way to manage a stressful situation.  The emotional impact of regressing to these primitive patterns causes further psychological damage in the result is usually feelings of guilt and shame. To be sure, giving in to food cravings does not do much to increase the coping capacity for future stressful situations. As these feelings increase, the cravings become all the more likely because they increase the feeling of stress. What this essentially means is that the method of managing the stressful situation has actually added to the original feelings of stress as oppose to reducing it. While it may have temporarily distracted from the uncomfortable feelings, the overall effect is negative. 

Knowing that stress is very highly linked to cravings and actually changing the situation that is leading to a feeling of stress are to very different concepts however. Part of the challenge in altering a difficult situation is due to the neurological impact of chronic stress. As we have discussed above, the elevated levels of epinephrine, and lowered levels of serotonin and dopamine, along with a reduced cognitive capacity, make cravings more likely, as well as making avoiding them very challenging. The first step is actually removing oneself from the situation long enough to see it clearly. For most people, when they can identify the ways they are experiencing stress, and how it is impacting them, change begins to look much more possible. As with most things, a little knowledge goes a long way.  

Claire Dorotik M.A. 

Taper Schmaper - Taper? You've got to be kidding? You want to lose that finely tuned conditioning you worked so hard for? That rapid leg turnover? Cut back? No way. Keep that consistent training going right up until a day before the race and to gain that psychological edge that you can go the distance - - it's always a great idea to do your last long run a few days before the marathon. This just reinforces that you've got what it takes. Don't worry about "dead legs" come race day, as adrenaline and fan support will overcome that.

Speedy Start - The key to a successful start is to place yourself as near to the front as possible. You want to get caught up in the faster pace of the elite runners and make certain you eclipse your planned pace per mile by a minute or so in those first few miles. This way you'll already be well ahead of your goal target and the mental boost you'll receive is immeasurable. Don't even think about negative splits. Just get as far ahead as quick as you can and the stimulus of the race will keep you going.

Bathroom Discipline - Let's talk anatomy. You drink fluids; you eventually have to expel. Do you want to have to stop for a port-a-potty at mile 18? I think not. The best way to avoid this is to forego all fluid offered at the various aid stations. You won't waste valuable time by slowing down to grab a drink and if you're really thirsty they'll be plenty of fluids available at the finish line. That's incentive to get going.

Coffee Combustion - Give yourself a great big kick-start. If you're a regular drinker then simply quadruple your normal intake. If you're new to the caffeine connection then three cups will do you just fine. Don't worry about upsetting your stomach as that's a small trade off for a good opening mile time.

Try Something Exciting - You've worked hard in preparation for the marathon and should reward yourself with something new and special for the race. Best thing would be a brand new pair of shoes or try a different make of socks or even a new breakfast cereal. Maybe Bran Buds! Mix things up a little for the big day.

Uphill, Downhill - If you encounter any hills you need to attack them vigorously. Get into some oxygen debt. Sprint up them as fast as humanly possible and then jog leisurely on the downhills. This way you'll get the hill out of the way faster and be able to enjoy the slow pace on the backside.

Goo Riddance - Do you think Frank Shorter won a gold medal downing gels or other goo's over the last ten miles? I think not as the only goo Frank was familiar with in the 70's was Shoe Goo and you wouldn't want to ingest that. Don't rely on a shot of strawberry banana flavored pudding like food to get you through the light headed feeling of mile 20. Just close your eyes and plow ahead.

Post Run Recovery - Once you cross that finish line you deserve to simply lay down. Don't expend any further energy and stop the strain train right there. Just take a seat and let those lactic acid pools build right up in your legs where they belong. You may be sore tomorrow but let's just think about today.

Claire Dorotik, M.A. is an ultra marathon runner licensed marriage and family therapist specializing in weight loss, and the founder of RUN WITH IT RACING LLC.