Reflections on Being a Patient

Reflections on Being a Patient

I will never get annoyed at a patient’s “lack of compliance” again.

Health care is scary, even when you know what you’re doing. When it’s your own health, putting yourself in the hands of a professional is not easy.

Yesterday I had an initial consult for myself with a nutrition specialist. She’s well-known in her field, super-academic, in her 70s, and has published books and papers.

She knows her stuff. She’s also really helped a friend of mine and the referral came from him. I had every reason to trust her and feel good about putting myself in her hands.

However, I was nervous getting ready to see her. I filled out a diet diary… what would she think? What would she say about my blood work? Would she be nice? Would she be understanding? Would we get along?

Survival instincts kick in.

We talked about a few things in the first visit (which cost an arm and a leg, but will be worth it if I’m left feeling great) and she prescribed some supplements for me to take.

I left, kind of satisfied. Ready to get on with our journey, with a list of things to pick up, dosages to tweak, things to consider and instructions to book again in 3 to 4 weeks.

Ok.

I woke up this morning, in the early hours tossing and turning, thinking to myself, “I don’t want to take vitamin E!” And “Did she truly understand my concerns?” And “what are all these supplements treating?” and “did she really hear me out?” And, “is all this going to actually help?”

The impulse to not trust, to run and hide, to override her assessment and recommendations with my own were overwhelming. (And, of course, as someone who does what she does for a living, the struggle to overcome this is real, we’re “experts” on the body, but it’s nice to let someone else give direction for a change, especially someone with 30+ more years’ experience).

Still, trusting is hard.

Being aware of the impulse to run and avoid, while also resisting the impulse, is hard.

I have people who neglect booking a follow-up even when they know that we still have lots of work to do.

I have people who don’t fill out diet diaries for fear of actually taking a hard look at their food intake.

I have people who email me that “nothing is working” when in fact they haven’t started taking their nutrients and supplements yet.

And, guess what, as frustrating as that may be (because ultimately, I want people to have success! I want people to heal), I’m doing the same thing.

Jeez, being in the patient chair is mighty humbling.

I highly recommend it to all my health practitioner colleagues out there.

And, yes, now I’m taking vitamin E. I’ve decided to just trust. (But I’m still taking my own multi-vitamin… hey, doctors make the worst patients… amiright?)

On Emotions and Eating

On Emotions and Eating

emotionsMy mother tells a story about my childhood where she is standing in the kitchen, preparing dinner. I stand below her, tugging at her shirt, and begging for food.

“I’m hungry”, I say, according to her recollection of that moment and many others like it; she says that as a child I was always preoccupied with food. My constant yearning for something munch got to the point where every time she tried to cook dinner, I’d follow her to the kitchen, like a hungry dog, and persistently beg for food. I was insatiable, she claims. But, as an adult looking back I wonder, insatiable for what?

I remember that moment, but from the third person perspective. So I wonder if it’s as past events sometimes go, where the telling of a memory from an outsider’s perspective serves to reshape it in the imagination. I can feel the emotions, however, watching my 4-year old form tugging on my mother’s clothing, her body towering over me, her face far away. She stands at the stove. I remember feeling full of… what was that yearning? Was it for food? Was it hunger for physical sustenance or nutrition from some other source? I wonder if the constant, nagging hunger was an articulation, in 4-year old vocabulary, of the need for something else: attention, affection or reprieve from boredom. I remember being told at one point that my favourite show was on and felt some of the anxiety of missing what I was lacking dissipate: a clue.

As a child, adults occupy the gateway to food. As adults, the gateways take on another form. Perhaps it is anxiety about body shape or the guilt of knowing that eating too much of a certain kind of thing isn’t nutritious. Perhaps the barrier to sustenance is financial. However, when I stand now in the kitchen, bent over the fridge, arm slung over the open door, contemplating a snack, I know that I am making a choice. And, for myself, as for many others, it’s not always clear whether the call to eat is hunger and physiologically based.

In the west, we have an abundance problem. More and more adults are reaching obese proportions. Metabolic diseases of excess like diabetes and cardiovascular disease are increasing and more and more women are experiencing the hormonal dysregulation that can come from carrying more body fat.

While I don’t recommend aspiring to the emaciated standard that we see plastered on magazines, Pinterest ads or runways, I do think that, for many people, balancing energy intake with energy output could be beneficial for optimal health and hormonal signalling. Body fat is metabolically active. It also stores toxins and alters that way our body metabolizes and responds to hormones, insulin being just one example, estrogen being another. Therefore, conditions like PCOS, infertility, diabetes, PMS and dysmenorrhea, or certain inflammatory conditions might benefit from a certain amount of weight loss.

An addition here: this post is not about body-shame or even necessarily about weight loss per se. It’s about overcoming emotional eating patterns that might even derive from the same disordered patterns that manifest in anorexia or bulimia. The goal of this post is to bring more awareness to how we operate within the complex relationships many of have with food and with our own bodies.

There are many reasons why we eat and physiological hunger is only one of them. Tangled up in the cognitive understanding of “hunger” is a desire for pleasure, a desire to experiment, to taste, to experience a food, to share with family and friends, to enjoy life. There are also deeply emotional reasons for wanting food: to nurture oneself, as reward, to combat boredom and to smother one’s emotions like anxiety, depression, ennui, yearning for something else— we often eat to avoid feeling.

Health issues aside, I believe that Emotional Eating (as it’s so-called) is problematic because it dampens our experience of living. By stuffing down our emotions by stuffing our faces we prevent ourselves from feeling emotions that it might be beneficial for us to feel in order to move through live in ways that are more self-aware, mature, self-developed and meaningful. While some emotional reasons to eat might be legitimate (acknowledging your beloved grandmother’s hard work by having a few bites of her handmade gnocchi, for instance), many of the reasons we eat linger below the surface of our conscious mind, resulting in us suffering from the consequences of psychological mechanisms that we are unaware of. I believe in making choices from a place of conscious awareness, rather than a place of subconscious suffering.

In heading directly into the reasons I am tempted to emotionally eat, I’ve learned quite a lot about myself. I’ve ended up eating less, as I’ve become more aware of the non-hunger-related reasons that I reach for a snack, but that doesn’t have to be the end goal for everyone. I believe that just understanding ourselves through uncovering and analyzing the emotions that influence our everyday behaviours can have life-changing effects; it allows us to know ourselves better.

As I work through the process of understanding why I overeat, I’ve realized there are a few steps to address. I believe that there are layers to the reasons we enact unconscious behaviours and first, it is important to untangle the physiological from the emotional reasons for eating, understand what real hunger feels like, address the “logical” reasons for overeating and then, when ready, head straight into the emotions that might cause overeating to occur

  1. Distinguishing between physiological hunger and emotional hunger:

The first step, of course, is to distinguish between physiological/physical hunger—the body’s cry for food, calories and nourishment—and emotional hunger. Typically, physiological hunger comes on slowly. It starts with a slow burn of the stomach, growling, a feeling of slight gnawing. It grows as the hours pass. For some it might feel like a drop in blood sugar (more on this later): feeling lower energy, dizzy and perhaps irritable. Physiological hunger occurs hours after the last meal, provided the last meal was sufficient. Usually, if one drinks water at this time, the physiological hunger subsides and then returns. Essentially, eating a meal or snack will result in the hunger vanishing and returning again still hours later.

Emotional hunger, however, is different. It starts with an upper body desire to eat. It might be triggered by commercials, social situations, or certain strong emotions. There might be cognitive reasons to eat (“I might be hungry later” or, “Oh! We’re passing by that taco place I like!”) that are not directly guided by the physical desire for sustenance. Emotional eating is often felt in the mouth, rather than the stomach. It might be brought on by the desire to taste or experience the food, rather than to fill oneself. The cravings might be specific, or for a certain food-source, such as cookies (this is not a hard and fast rule, however). Emotional hunger does not vanish from drinking water. Emotional hunger comes on suddenly, and is often not relieved by eating the prescribed amount of food (having a full meal); oftentimes we finish lunch only to find ourselves unable to get the cookies at the downstairs coffee shop out of our heads.

2. Settling hormonal reasons for overeating: serotonin, insulin, cortisol:

Not all physiological hunger, however, is experienced as the slow, gnawing, slightly burning, grumbling stomach sensation described above. Sometimes we experience the need to eat because our blood sugar has crashed, or our neurological needs for serotonin have gone up. We might eat because stress hormones have caused blood sugar to spike and then crash. We might also experience certain cravings for food because our physiological needs for macronutrients; like carbs, fat or protein; or micronutrients, like sodium or magnesium, have not been met.

Therefore, it becomes essential to address the hormonal imbalances and nutritional deficiencies that might be causing us to overeat. Oftentimes, getting off the blood sugar rollercoaster is the first step. This often involves a combination of substituting sugar and refined flours for whole grains, increasing fats and protein, and, of course, avoiding eating carbohydrate or sugar-rich foods on their own. It often involves having a protein-rich breakfast. I tend to address this step first whenever my patients come in and express feeling “hangry”: irritable and angry between mealtimes.

Often drops in brain-levels of serotonin cause us to crave carbohydrate-rich foods. This is very common for women experiencing PMS. In this case, balancing hormones, and perhaps supplementing with amino acids like l-glutamine, tryptophan and 5-HTP, can go a long way.

One of the questions I ask my patients who crave a snack at 2-3 pm (a mere 2-3 hours after their lunchtime meal), assuming their lunch contained adequate nutrients, is “Do you crave, sugar, caffeine, salt or a combination of the above?” Cravings for sugar or salt at this time might indicate a drop in cortisol and give us a clue, combined with the presence of other symptoms, that this person is in a state of chronic stress, burnout or adrenal fatigue. In this case, it is essential to support the adrenal glands with herbs, nutrients, rest, and consuming adequate protein during the afternoon crash.

Finally, when it comes to cravings for foods like chocolate, meat or nuts, or even specific vegetables (when living in South America I would experience over-whelming cravings for broccoli, funnily enough), I find it important to identify any nutrient deficiencies. It is common to experience a deficiency in something like magnesium, iron, selenium, zinc, and the fat-soluble vitamins A, D, E and K; and our bodies will do their best to beg us for the specific foods they’ve come to learn contain these nutrients. Either consciously eating more of these foods (like brazil nuts in order to obtain more selenium), preferably in their healthiest form (such as dark chocolate, as opposed to milk chocolate, to obtain magnesium), or directly supplementing (in the case of severe deficiency), often results in the cravings diminishing.

3. The Hunger Scale and food diaries:

One of the first things I have patients do is understand the Hunger Scale. There are a variety of these scales on the internet that help us cognitively understand the stages the body goes through on its quest to ask for food and it’s attempt to communicate fullness. Being able to point to certain levels of hunger and fullness and pinpoint those physiological feelings on the Hunger Scale allows us to further flush out the subtleties between a physical or emotional desire for food.

Food diaries, I find, can help bring more awareness to one’s daily habits. Oftentimes, keeping a food diary for a few weeks is enough for some patients to drop their unwanted eating behaviours altogether. Other times, it can help us detect food sensitivities and unhealthier eating patterns or food choices. It also helps me, as a practitioner, work off of a map that illustrates a patient’s diet and lifestyle routines in order to avoid imposing my own ideas in way that may not be sustainable or workable for that particular individual.

A word about diet diaries, however: when recording food for the purpose of uncovering emotional eating behaviours, I often stress that it is important to record every single food. Sometimes people will avoid writing in their diary after a binge, or outlining each food eating when they feel that they’ve lost control, writing instead “junk food”. Guilt can keep us from fully confronting certain behaviours we’d rather not have acted out. However, I want to emphasize that the diary is not a confession. It’s not, nor should it be, an account of perfect eating or evidence that we have healed. Keeping a diet diary is simply a tool to slow down our actions and examine them. It’s a means of finding out how things are, not immediately changing them into what we’d like them to be. This is an important reminder. The best place to start any investigation into being is from a place of curiosity. Remember that the point of this exercise is to observe and record, not necessarily to change, not yet; it is very difficult or even, I would argue, impossible to completely eradicate a behaviour if the reasons for engaging in that behaviour escape our conscious awareness.

Therefore, recording food allows us to begin to poke at the fortress that contains the subconscious mind. We start to slow down and uncouple the thoughts and emotions from the actions that they precede and, in doing so, develop some insights into how we work. It can also help to start jotting down other relevant points that might intersect with what was eaten. These pieces of information might include time of day, where you were, what thoughts were popping into your head, and how you felt before and after eating the food. As we observe, more information begins to enter our conscious experience, allowing us to better understand ourselves.

4. Pealing back the layers: Understanding the “practical” and logical reasons for overeating:

One of the things that I have noticed, through my own work with addressing emotional eating, is that there are often layers to the “reasons” one might overeat. Some of the first layers I encountered were cognitive, or seemingly “logical” reasons. For example, I noticed that before eating without hunger I might justify it by thinking “I need to finish the rest of these, I don’t want them to go to waste”, or “I’ll finish these in order to clean out the container”, or “I should eat something now so I won’t be hungry later”, or “I didn’t eat enough (insert type of food) today so I’ll just eat something now, for my health”, or “If I don’t have some (blank) at so and so’s house, she’ll be offended”.

When looking more closely into these justifications, I found them to be flawed. However, they were logical enough for me to eat for reasons other than to satisfy a legitimate, physiological yearning for nutrients. It’s interesting to see how the mind often tries to trick us into certain behaviours and how we comply with its logic without argument.

5. Addressing the practical reasons: Planning:

In order to address the first layer of rationale for eating when not hungry, I decided to do the following: I would plan my next meal and either have it ready in the fridge, or pack it with me to go, and then I would wait all day until I was hungry enough to eat it. I would repeatedly ask myself, every time I thought of reaching for my portions, “Am I hungry now?” And would answer that question with, “Is there a rumbling in my stomach? No? Then it’s not time to eat.”

I found it would often be a several hours later before my body would genuinely ask for the food. I also found that eating satisfied the physical hunger often much sooner than it took me to finish the food. I realized how I often eat much more food and much more often, than I genuinely need.

However, holding off eating until physical hunger arises takes a conscious effort that is often unsustainable. Few of us can move through our busy lives constantly asking ourselves how hungry we are and when, and then have food at the ready to satisfy that hunger with appropriate, healthy choices. Therefore, I used this practice as a mere stepping stone to move through the deeper layers of emotional eating. By addressing the rational and logical reasons for overeating, I was able to get in touch with the deeper, emotional (and, arguably, real) reasons for which I was eating without hunger.

6. Pealing back the layers: Understanding the deeper, emotional reasons for overeating:

For a while I would wake up, make myself a coffee, and then wait until I felt hungry. Sometimes the feeling would arise in a few minutes, sometimes it would take hours. Depending on what I’d eaten the previous day and what my activity levels were, I would often not get hungry until well into the afternoon. However, the thoughts of eating something would frequently persist. And when the thoughts came up, whereas before they would be satisfied by me having something to eat, I now resisted them. When I resisted the thoughts, their associated emotions would strengthen. I then decided to journal before reaching for food, especially when I wasn’t sure if I was actually hungry or not.

Journalling can help us pull up, process and make sense of some of our emotions. I would write about what I might be feeling—what I might be asking for that wasn’t food. Through doing this, emotional reasons for hunger began to surface. The more I held off eating, the stronger and more clear the emotions became. It was a deeply uncomfortable process. This is why we emotionally eat—removing the emotions is often far more pleasant than dealing with them.

Emotions that surfaced were anxiety, ennui, boredom, loneliness and sometimes even anger. However, boredom and a listless, almost nihilistic, sense of ennui were among the two most common emotions I realized that eating medicated for me. For me, eating was entertainment. It broke up the monotony of the day and gave my senses something to experience. It gave my body something to do: chewing, tasting and digestion. Not eating made that sense of boredom grow stronger.

7. Addressing the emotional reasons: Nurturing and preventing:

Knowing more about the root emotional causes for overeating allowed me to work more closely with the source of my behaviour. I find that the closer we get to the source, to the roots, the more effective we are at removing the weeds, or behaviours, from our lives. I knew now that if I didn’t want to overeat, I would have to prevent myself from getting bored. I would have to have checklists of things to do. I would stay active and engaged in life: in my work, my friendships, and the other non-food-related things that brought meaning to my life.

During this time, I did more yoga and meditated. I journaled and wrote. I also meditated on boredom. I traced it back to where I might have felt it in my life before and noticed themes of boredom in my childhood. I realized that the child tugging on her mother’s shirt and asking when dinner was ready was probably a child who needed something to do, a child who was bored.

8. Pealing back the layers further: Working directly with core emotions:

Going even further, we can begin to peal back the layers of the emotional reasons for overeating in order to avoid replacing one “addiction” with another—such as replacing overeating with over-busying oneself, distraction or overworking. I began to find other emotions that ran deeper than mere boredom. I also realized that whenever I had felt boredom in the past, there was a threshold, often filled with discomfort, that I would eventually surpass. Once surpassing this threshold, a well of creativity, or a plethora of interesting insights, would spring forth. I remember as a child I would create stories, or lie on my bed and stare that the ceiling of my bedroom, contemplating the nature of the universe. These beautiful moments had been made possible by boredom and my courage to not distract myself from it.

Working with a therapist, or doing some deep inner work, we can access the core beliefs and emotions that might cause these emotional reasons for overeating to exist. Oftentimes we encounter core beliefs whose effects spill out into other areas of our lives, preventing us from living fully and consciously. Working through these beliefs can be deeply satisfying and help us experience transformational self-growth.

9. Setbacks: Understanding Change Theory:

Finally, engaging in this process of self-discovery doesn’t follow the same pattern in every person. Some people may find that their reasons for overeating are dissolved as soon as they start recording the foods they eat (this is surprisingly common). Others might find that years of working with a therapist have resulted in a mere dent in their ability to eat in response to hunger and to stop unwanted eating behaviours. In most everyone progress is not linear.

Change Theory and the Stages of Change schema depicts the alteration of behaviours as cyclical, rather than linear. As we move through the stages, we enter a cycle of pre-contemplation, contemplation, planning, action and maintenance. Sometimes we fall out of the cycle and relapse. Many people working with behavioural changes and addictions prefer to rename relapse “prolapse”, claiming that prolapse is a necessary stage for continuing the cycle of change and that much is to be learned from failing at something. It is through observing how the world produces unexpected results, and then attempting to understand the unexpected while trying again, where learning takes place. We don’t really learn if we don’t fail.

Sometimes addictive behaviours, emotional eating included, worsen at a time when someone is on the verge of making a massive breakthrough. Sometimes poking at a new layer of the source of unwanted behaviour accompanies an exacerbation in the practice of that behaviour. Having curiosity and self-compassion throughout the process is essential. Savouring the increased self-awareness that comes with any effort to effect change in one’s life is part of the enjoyment of the experience.

On Healing Regret

On Healing Regret

regretSomeone, I think it was Eckhart Tolle, once said that when it comes to mental illness, anxiety is about worry for the future, while depression is concerned with regret for the past. While, I’m not entirely (or even nearly) convinced that this is true, there is little doubt that those with both depression and anxiety can get caught in the paralysis of going over past events and regrets in their minds. Therefore, healing regret becomes important for reframing our past experiences and present identity and improving mood and self-esteem.

Regret is a sticky emotion. It reminds us of who we once were. It’s the cold hand on the shoulder and the voice that whispers “remember…” in our ear when we’re getting a little too confident, when we’re actually feeling happy with who we are now.

My patients will often tell me that when they find themselves in a spiral of low mood, their minds are often playing and replaying past events over and over. They mull over painful memories until they are distorted, painting themselves as the villain the more they rewind and press play. Remembering in this way smears grey over their entire sense of self, and discolours the possibilities they see for themselves in the future and, worse, their abilities to take meaningful action in the present. It leads to deep feelings of self-hate and worthlessness.  It causes feelings of hopelessness. And so I tell them this:

Regret, while painful, is not always bad. It is a reflection, a comparison between two people: the person you are now and the person you used to be. When this comparison is particularly vast, when the you you used to be is particularly painful to remember, then know this; you have changed. Regret comes with looking back with pain, wishing we’d taken a different course of action than the ones taken. However, when we flip this concept over and examine its shinier underbelly, we realize that in order to feel regretful about past events we are acknowledging that we (present we) would not have performed the same action or made the same choice now. The flip side is not that we’re bad, it’s a reflection of our goodness. We have learned and evolved. We’re different.

Looking back is different from looking forward. Our lessons are what shape us. The fact that we regret is proof that we learn, we grow and we change into better, preferred versions of ourselves. If we sit in the experience of regret, we can feel proud that, if faced with the same situation today, we’d be better. Regret doesn’t mean that we are bad people, it’s proof that we’re good people. In order to regret the past we’ve had to have changed.

To transform mulling over painful life choices and past actions, I recommend a writing exercise, inspired by Narrative Therapy. In every story of regret and “badness” there is also a story of values, skills, preferred identity and goodness. The next time you find yourself cycling through feelings of regret grab a pen and paper and answer the following questions:

1) What happened? What were the events that transpired? What did you do? What did other people in the story do? What were the events leading up to the action you and others took? What was the context surrounding you at the time? What influenced your decision to act as you did?

2) Looking back, what would you have done differently? What parts are particularly painful to remember? What actions or events do you regret?

3) What might these regrets say about you now? What might it say about you to know that you would have acted differently if you were faced with the same situation? What values do you embody that enable you to recognize that what you did in the past was regretful for you?

4) Looking at these values, how have you shown you have this value in the past in other situations? Do you have a particular story you remember?

5) How has that value or skill made an impact on the lives of others? In the story that you remembered, what might the actions you took in #4 have meant to the people around you?

6) How do you embody this value in the present? Where does it show up in the actions you take today? How might you embody this value in the future? What actions might you take while remembering this value? What does remembering this value and the story from #4 make possible for the future?

Going through this writing exercise can help us look back with more compassion for the person we were, who was growing into the person we are now. It might make possible ways that we can rectify anyone or anything was impacted in the past, if it means an apology, paying forward a good act, taking different steps in a similar present situation or even moving on and letting go of our tendency to hold onto the memory.

30 Years, 30 Insights

30 Years, 30 Insights

30Today, I’m 30, working on my career as a self-employed health professional and a small business owner and living on my own. I’ve moved through a lot of states, emotions and life experiences this year, which has been appropriate for closing the chapter on my 20’s and moving into a new decade of life. I’ve experienced huge changes in the past year and significant personal growth thanks to the work I’ve been blessed to do and the people who have impacted me throughout the last 30 years. Here are 30 things this past year has taught me.

  1. Take care of your gut and it will take care of you. It will also eliminate the need for painkillers, antidepressants, skincare products, creams, many cosmetic surgeries, shampoo and a myriad of supplements and products.
  2. Trying too hard might not be the recipe for success. In Taoism, the art of wu wei, or separating action from effort might be key in moving forward with your goals and enjoying life; You’re not falling behind in life. Additionally, Facebook, the scale and your wallet are horrible measures to gauge how you’re doing in life. Find other measures.
  3. If you have a chance to, start your own business. Building a business forces you to build independence, autonomy, self-confidence, healthy boundaries, a stronger ego, humility and character, presence, guts and strength, among other things. It asks you to define yourself, write your own life story, rewrite your own success story and create a thorough and authentic understanding of what “success” means to you. Creating your own career allows you to create your own schedule, philosophy for living and, essentially, your own life.
  4. There is such as thing as being ready. You can push people to do what you want, but if they’re not ready, it’s best to send them on their way, wherever their “way” may be. Respecting readiness and lack thereof in others has helped me overcome a lot of psychological hurdles and avoid taking rejection personally. It’s helped me accept the fact that we’re all on our own paths and recognize my limitations as a healer and friend.
  5. Letting go is one of the most important life skills for happiness. So is learning to say no.
  6. The law of F$%3 Yes or No is a great rule to follow, especially if you’re ambivalent about an impending choice. Not a F— Yes? Then, no. Saying no might make you feel guilty, but when the choice is between feeling guilty and feeling resentment, choose guilt every time. Feeling guilty is the first sign that you’re taking care of yourself.
  7. Patience is necessary. Be patient for your patients.
  8. Things may come and things may go, including various stressors and health challenges, but I will probably always need to take B-vitamins, magnesium and fish oil daily.
  9. Quick fixes work temporarily, but whatever was originally broken tends to break again. This goes for diets, exercise regimes, intense meditation practices, etc. Slow and steady may be less glamorous and dramatic, but it’s the only real way to change and the only way to heal.
  10. When in doubt, read. The best teachers and some of the best friends are books. Through books we can access the deepest insights humanity has ever seen.
  11. If the benefits don’t outweigh the sacrifice, you’ll never give up dairy, coffee, wine, sugar and bread for the long term. That’s probably perfectly ok. Let it go.
  12. Patients trust you and then they heal themselves. You learn to trust yourself, and then your patients heal. Developing self-trust is the best continuing education endeavour you can do as a doctor.
  13. Self-care is not selfish. In fact, it is the single most powerful tool you have for transforming the world.
  14. Why would anyone want to anything other than a healer or an artist?
  15. Getting rid of excess things can be far more healing than retail therapy. Tidying up can in fact be magical and life-changing.
  16. It is probably impossible to be truly healthy without some form of mindfulness or meditation in this day and age.
  17. As Virginia Woolf once wrote, every woman needs a Room of Own’s Own. Spending time alone, with yourself, in nature is when true happiness can manifest. Living alone is a wonderful skill most women should have—we tend to outlive the men in our lives, for one thing. And then we’re left with ourselves in the end anyways.
  18. The inner self is like a garden. We can plant the seeds and nurture the soil, but we can’t force the garden to grow any faster. Nurture your garden of self-love, knowledge, intuition, business success, and have faith that you’ll have a beautiful, full garden come spring.
  19. Be cheap when it comes to spending money on everything, except when it comes to food, travel and education. Splurge on those things, if you can.
  20. Your body is amazing. Every day it spends thousands of units of energy on keeping you alive, active and healthy. Treat it well and, please, only say the nicest things to it. It can hear you.
  21. If you’re in a job or life where you’re happy “making time go by quickly”, maybe you should think of making a change. There is only one February 23rd, 2016. Be grateful for time creeping by slowly. When you can, savour the seconds.
  22. Do no harm is a complicated doctrine to truly follow. It helps to start with yourself.
  23. Drink water. Tired? Sore? Poor digestion? Weight gain? Hungry? Feeling empty? Generally feeling off? Start with drinking water.
  24. Do what you love and you’ll never have to work a day in your life. As long as what you love requires no board exams, marketing, emailing, faxing, charting, and paying exorbitant fees. But, since most careers have at least some of those things, it’s still probably still preferable to be doing something you love.
  25. Not sure what to do? Pause, count to 7, breathe. As a good friend and colleague recently wrote to me, “I was doing some deep breathing yesterday and I felt so good.” Amen to that.
  26. As it turns out, joining a group of women to paint, eat chocolate and drink wine every Wednesday for two months can be an effective form of “marketing”. Who knew?
  27. “Everyone you meet is a teacher”, is a great way to look at online dating, friendships and patient experiences. Our relationships are the sharpest mirrors through which we can look at ourselves. Let’s use them and look closely.
  28. Being in a state of curiosity is one of the most healing states to be in. When we look with curiosity, we are unable to feel judgment, anxiety, or obsess about control. Curiosity is the gateway to empathy and connection.
  29. Aiming to be liked by everyone prevents us from feeling truly connected to the people around us. The more we show up as our flawed, messy, sometimes obnoxious selves, the fewer people might like us. However, the ones who stick around happen to love the hot, obnoxious mess they see. As your social circle tightens, it will also strengthen.
  30. If everyone is faking it until they make it, then is everyone who’s “made” it really faking it? These are the things I wonder while I lie awake at night.

Happy Birthday to me and happy February 23rd, 2016 to all of you!

Will That Be Form or Function Today?

Will That Be Form or Function Today?

I’ve come to see my migraines as an internal measuring device for wellness, or rather, lack of wellness—kind of like a very painful meat thermometer. From time to time I get bouts of low energy compelling me to spend more time doing low-key activities. However, quick browses through Facebook show me busy colleagues achieving great things and I feel guilty about my relative inaction. A little voice pipes up. “Your body is telling you to rest”, it says. “But if you just started doing things, you’d probably feel more motivation”, voices another, its opponent, the devil on my shoulder. A war ensues and then a headache settles it all. I take it easy for a while, while I’m literally knocked out of commission, in the dark, on the couch with an icepack on my head. New Doc 55_1

 

L came to me for fertility, which is another litmus test for good health. When the body is struggling against some sort of imbalance or obstacle to wellness, it will not spend its resources readying eggs, ovulating and ripening uteruses. Our bodies protect us from the metabolic demands of having a pregnancy, which in our current stressed-out, unwell states we probably wouldn’t be able to handle, by simply not getting pregnant in the first place. And so, infertility is a nice entry-way to healing—patients are motivated to examine the effect of their lifestyles on their wellbeing.

The problem was, however, that L barely had time to make and attend her appointments. When she did manage to come in, she was in a rush. She’d often cancel follow-ups because she hadn’t followed through with the previous visit’s plan, even though it had been weeks before. She also reported working 50-hour weeks and staying up early into the morning to work on projects. I wondered, if she couldn’t even make an hour-long appointment with her naturopathic doctor, how would she manage growing and then giving birth to and then raising a brand new human? L simply might have not been ready to heal. Something in me fought to give her my professional assessment; in order to have the baby she wanted, she might have to give up, or significantly let up on, the demands of her job. However, how could I have made such a statement? I held my tongue and tried my best with the modalities at my disposal. We did acupuncture, CoQ10, PQQ and herbal remedies. We worked on sleep and did stress management with adaptogens. In a few months, despite the high demands of her lifestyle, L was pregnant. She still has trouble keeping her appointments with me. L’s body may now be functioning fine, but is it thriving?

Workplace wellness programs teach employees how to survive the 60+ hour workweeks in the office by doing yoga at lunch and eating healthier cafeteria food. They’re taught about stress management and, in the best of cases, given adaptogens and B-vitamins to help their bodies’ sails weather the stress-intensive storms of office life. It’s a great investment, these programs proclaim, because employees are happier, more efficient at their work and take less sick days. Workplace wellness programs keep their employees functional but, I wonder, can anyone really be well working that many hours a week?

When it comes to the health strategies we promote as a profession, how many of them are geared towards healing and how many of them are really just there to help us function?

At this stage in my career, I often have to gauge what my patients want. There are some people who come in ready to heal. They want to search for and address the real root cause of disease, no matter how elusive it may be. They are also willing to do what it takes to get better, even if it means a significant lifestyle shift. Sometimes these patients are at a point where things have gotten so bad that they have no other choice, however some of them simply intuit that the symptoms arising may be conveying a greater message; in order to be truly healthy, things might have to change. Most patients, however, come in looking to “feel better”—they simply want their symptoms to go away so they can get back to their daily lives, lives that might have made them sick in the first place. In our pharmaceutical-based Therapeutics and Prescribing exam, the goal of therapy in the oral cases was always to “restore functioning”, as if our patients were simply pieces of machinery; our parts are worn, maybe broken and we’ve gone decades without a decent oil change, but the factory declares we must get back to work as soon as possible and so we break out the duct tape. With this mindset, however, are we simply placating our bodies long enough to keep working until we eventually succumb to the next thing, a debilitating headache instead of mild fatigue, or something even worse? How long can we go suppressing symptoms or getting our bodies into decent enough shape before we realize that what we really need is some honest-to-goodness authentic healing?

Jiddu Krishnamurti, Hindu philosopher and teacher once said, “It is no measure of health to be well-adjusted to a profoundly sick society.” How much of our health marketing and wellness efforts are aimed at cleaning out the cogs in a jammed up machine so that they can go on turning smoothly again? The thought that real healing might mean dismantling the entire machine might be too radical for our society to handle. How can we address the problem of making a living if we acknowledge the fact that our lifestyle, or job, might be making us sick?

A therapist I work with (doctors need healing too!) once told me that mild to moderate depression is a sign that something in your life needs changing. “Look at the symptoms of depression,” She told me one afternoon in her office, “You lose the energy and motivation to keep going with your routine. You stop being social; all of your energy turns inwards. You focus your attention on your self and your life so that you can examine what about it is making you unhappy. Then you change it.” Then you change it, a scary thought. No wonder a tenth of the population opts for anti-depressant medication, which in some cases might be the medical equivalent of dusting oneself off and heading back to work. And, while they seem like more benign options, St. John’s Wort, B12 injections and 5HTP may not be that different.

A friend and I were talking about this very topic. He remarked that at a fitness retail store he worked at he’d often ask his female customers, “What will you be needing these yoga pants for today: form or function?” When I laughed at the shallowness of it all, he protested, “Well, some people are just going to use them to sit in coffee shops while others want to actually work out. What’s going to make your butt look great won’t necessarily be the best choice at the gym. I had to know their motivations.” Are most of our wellness efforts aimed at making our butts look great or are they filling a functional purpose?

I wonder if I should follow my friend’s lead and outright ask my patients, maybe on their intake forms, “Are you looking to truly heal today or do you just want to feel better and get back to work?”—form or function? Being candid with them, might help me decide when to schedule follow-up appointments. At any rate, it would definitely open up a conversation about expectations surrounding decent time-frames for seeing “results” and what true healing might look like for them. The trouble is, restoring functioning, if not easier, is more straight-forward. You make some tweaks to diet, correct some nutritional deficiencies and boost the adrenals or liver. It’s the medical equivalent of filling in potholes with cheap cement—it might not look pretty, but now you can drive on it. Healing, however, is more complex. It’s more convoluted, hard to define and get a firm grasp on. It is also highly individual. It might mean ripping up the entire road, plumbing and all, and building a new one or, even better, planting grass and flowers in the road’s place and nurturing that grass on a daily basis. Healing might be creating something entirely new, something that no one has ever heard of or seen before. Creating is scary. Creativity takes courage, and so does healing.

No matter what it might look like, I believe healing begins with a conversation and a willingness to look inwards, without judgement. Healing also requires an acceptance of what is, even if the individual doesn’t feel ready to take actions to heal just yet. Healing deserves us acknowledging that something is a band-aid solution. Healing definitely demands listening, especially to the body. Therefore, healing might begin in meditation. It might start with a mind-searing migraine that lands you on the couch and the thought, “What if, instead of reaching for the Advil, I just rested a little bit today?” Healing might just start there and it might never end. But, if it does, who knows where it might end up?

Naturopathic Narrative Therapy

Naturopathic Narrative Therapy

narrativeAs a child, I was obsessed with stories. I wrote and digested stories from various genres and mediums. I created characters, illustrating them, giving them clothes and names and friends and lives. I threw them into narratives: long stories, short stories, hypothetical stories that never got written. Stories are about selecting certain events and connecting them in time and sequence to create meaning. In naturopathic medicine I found a career in which I could bear witness to people’s stories. In narrative therapy I have found a way to heal people through helping them write their life stories.

We humans create stories by editing. We edit out events that seem insignificant to the formation of our identity. We emphasize certain events or thoughts that seem more meaningful. Sometimes our stories have happy endings. Sometimes our stories form tragedies. The stories we create shape how we see ourselves and what we imagine to be our possibilities for the future. They influence the decisions we make and the actions we take.

We use stories to understand other people, to feel empathy for ourselves and for others. Is there empathy outside of stories?

I was seeing R, a patient of mine at the Yonge Street Mission. Like my other patients at the mission health clinic, R was a young male who was street involved. He had come to see me for acupuncture, to help him relax. When I asked him what brought him in to see me on this particular day, his answer surprised me in its clarity and self-reflection. “I have a lot of anger,” He said, keeping his sunglasses on in the visit, something I didn’t bother to challenge.

R spoke of an unstoppable rage that would appear in his interactions with other people. Very often it would result in him taking violent action. A lot of the time that action was against others. This anger, according to him, got him in trouble with the law. He was scared by it—he didn’t really want to hurt others, but this anger felt like something that was escaping his control.

We chatted for a bit and I put in some acupuncture needles to “calm the mind” (because, by implication, his mind was not currently calm). After the treatment, R left a little lighter with a mind that was supposedly a little calmer. The treatment worked. I attributed this to the fact that he’d been able to get some things off his chest and relax in a safe space free of judgment. I congratulated myself while at the same time lamented the sad fact that R was leaving my safe space and re-entering the street, where he’d no doubt go back to floundering in a sea of crime, poverty and social injustice. I sighed and shrugged, feeling powerless—this was a fact beyond my control, there wasn’t anything I could do about it.

The clinic manager, a nurse practitioner, once told me, “Of course they’re angry. These kids have a lot to be angry at.” I understood theoretically that social context mattered, but only in the sense that it posed an obstacle to proper healing. It is hard to treat stress, diabetes, anxiety and depression when the root causes or complicating factors are joblessness, homelessness and various traumatic experiences. A lot of the time I feel like I’m bailing water with a teaspoon to save a sinking ship; my efforts to help are fruitless. This is unfortunate because I believe in empowering my patients. How can I empower others if I myself feel powerless?

I took a Narrative Therapy intensive workshop last week. In this workshop we learn many techniques for empowering people and healing them via the formation of new identities through storytelling. In order to do this, narrative therapy extricates the problem from the person: the person is not the problem, the problem is the problem. Through separating problems from people, we are giving our patients the freedom to respond to or resolve their problems in ways that are empowering.

Naturopathic doctors approach conditions like diabetes from a life-style perspective; change your lifestyle and you can change your health! However, when we fail to separate the patient from the diabetes, we fail to examine the greater societal context that diabetes exists in. For one thing, our culture emphasizes stress, overwork and inactivity. The majority of food options we are given don’t nourish our health. Healthy foods cost more; we need to work more and experience more stress in order to afford them. We are often lied to when it comes to what is healthy and what is not—food marketing “healthwashes” the food choices we make. We do have some agency over our health in preventing conditions like diabetes, it’s true, but our health problems are often created within the context in which we live. Once we externalize diabetes from the person who experiences it, we can begin to distance our identities from the problem and work on it in creative and self-affirming ways.

Michael White, one of the founders of Narrative Therapy says,

If the person is the problem there is very little that can be done outside of taking action that is self-destructive.

Many people who seek healthcare believe that their health problems are a failure of their bodies to be healthy—they are in fact the problem. Naturopathic medicine, which aims to empower people by pointing out they can take action over their health, can further disempower people when we emphasize action and solutions that aim at treating the problems within our patients—we unwittingly perpetuate the idea that our solutions are fixing a “broken” person and, even worse, that we hold the answer to that fix. If we fail to separate our patients from their health conditions, our patients come to believe that their problems are internal to the self—that they or others are in fact, the problem. Failure to follow their doctor’s advice and heal then becomes a failure of the self. This belief only further buries them in the problems they are attempting to resolve. However, when health conditions are externalized, the condition ceases to represent the truth about the patient’s identity and options for healing suddenly show themselves.

While R got benefit from our visit, the benefit was temporary—R was still his problem. He left the visit still feeling like an angry and violent person. If I had succeeded in temporarily relieving R of his problem, it was only because had acted. At best, R was dependent on me. At worst, I’d done nothing, or, even worse, had perpetuated the idea that there was something wrong with him and that he needed fixing.

These kids have a lot to be angry at,

my supervisor had said.

R was angry. But what was he angry at? Since I hadn’t really asked him, at this time I can only guess. The possibilities for imagining answers, however, are plentiful. R and his family had recently immigrated from Palestine, a land ravaged by war, occupation and racial tension. R was street-involved, living in poverty in an otherwise affluent country like Canada. I wasn’t sure of his specific relationship to poverty, because I hadn’t inquired, but throughout my time at the mission I’d been exposed to other narratives that may have intertwined with R’s personal storyline. These narratives included themes of addiction, abortion, hunger, violence, trauma and abandonment, among other tragic experiences. If his story in any way resembled those of the other youth who I see at the mission, it is fair to say that R had probably experienced a fair amount of injustice in his young life—he certainly had things to be angry at. I wonder if R’s anger wasn’t simply anger, but an act of resistance against injustice against him and others in his life: an act of protest. 

“Why are you angry?” I could have asked him. Or, even better, “What are you protesting?”

That simple question might have opened our conversation up to stories of empowerment, personal agency, skills and knowledge. I might have learned of the things he held precious. We might have discussed themes of family, community and cultural narratives that could have developed into beautiful story-lines that were otherwise existing unnoticed.

Because our lives consist of an infinite number of events happening moment to moment, the potential for story creation is endless. However, it is an unfortunate reality that many of us tell the same single story of our lives. Oftentimes the dominant stories we make of our lives represent a problem we have. In my practice I hear many problem stories: stories of anxiety, depression, infertility, diabetes, weight gain, fatigue and so on. However, within these stories there exist clues to undeveloped stories, or subordinate stories, that can alter the way we see ourselves. The subordinate stories of our lives consist of values, skills, knowledge, strength and the things that we hold dear. When we thicken these stories, we can change how we see ourselves and others. We can open ourselves up to greater possibilities, greater personal agency and a preferred future in which we embrace preferred ways of being in the world.

I never asked R why the anger scared him, but asking might have provided clues to subordinate stories about what he held precious. Why did he not want to hurt others? What was important about keeping others safe? What other things was he living for? What things did he hope for in his own life and the lives of others? Enriching those stories might have changed the way he was currently seeing himself—an angry, violent youth with a temper problem—to a loving, caring individual who was protesting societal injustice. We might have talked about the times he’d felt anger but not acted violently (he’d briefly mentioned turning to soccer instead) or what his dreams were for the future. We might have talked about the values he’d been taught—why did he think that violence was wrong? Who taught him that? What would that person say to him right now, or during the times when his anger was threatening to take hold?

Our visit might have been powerful. It might have opened R up to a future of behaving in the way he preferred. It might have been life-changing.

It definitely would have been life-affirming. 

Very often in the work we do, we unintentionally affirm people’s problems, rather than their lives.

One of the course participants during my week-long workshop summed up the definition of narrative therapy in one sentence,

Narrative therapy is therapy that is life-affirming.

And there is something very healing in a life affirmed.

More: 

The Narrative Therapy Centre: http://www.narrativetherapycentre.com/

The Dulwich Centre: http://dulwichcentre.com.au/

Book: Maps of Narrative Practice by Michael White

 

How to Reinvent Your Life in 20 Steps

How to Reinvent Your Life in 20 Steps

New Doc 7_1According to James Altucher, author and entrepreneur, it is possible to reinvent yourself in 5 years. In his book, The Power of No, he tells us how to reinvent our lives by first saying a big, fat No to all the things that don’t serve us—toxic friendships and relationships, stagnant 9-5’s, harmful behaviours, negative thought patterns and, well, just things we simply don’t want to do—in order to free up our lives for greater happiness, abundance and creativity.

It is now the end of May. For me, May has been a month of reinvention. For the past 10 years it has been the month of closing and good-byes, specifically the end of the school year. The Canadian College of Naturopathic Medicine class of 2015 has graduated, as I did last year. Last week my Facebook feed was infiltrated with pictures of flowers, long black gowns and tearfully heartfelt thank-yous to the friends and family that got my colleagues through their gruelling 4 years of naturopathic medical education. Last year that was me—I remember the black gowns, the face-ache from smiling, drinking a little too much at grad formal and winning an award (“Most Likely to Write a Best Seller”—complete with misspelling of “bestseller”) while eating Portuguese chicken at my house afterwards with my friend F and his family. This year, one year later, I watch these events from afar. May 2014 offered new beginnings and chance for reinvention. I was dating, enjoying the sunshine, looking forward to a trip to India, looking forward to beginning a practice as a naturopathic doctor. Mostly, last May was about the death of one life—that of a naturopathic student—and the birth of a new one: a complete reinvention.

This year the rest of my life stretches before me like one long expansive road. My career is underway. My dating life is stagnant. The next steps are more like small evolutions rather than massive, monumental milestones. I most likely will not don a black gown again, but I can reinvent myself by following the 20 steps below. I can always check back into these practices when I’m feeling stuck, alone or afraid. When life is not going my way, there is always a chance to begin a reinvention of some sort. And, I remind myself, my current reinvention is likely well underway. Since I graduated last May, I have been in the process of reinventing: just 4 more years left until I complete my obligatory 5. While 4 years sounds like a long time, I know from experience that 4-year cycles turn over within the blink of an eye.

What stage are you on in your own personal reinvention? Wherever you are, follow these steps to reinvent yourself:

1) Say no. Say no to all the things that you don’t want to do. Say no to things that cause you harm: emotional harm, mental harm, physical harm, loss of time, loss of money, loss of sleep. We need to say no first before we can free up the time and energy to say yes to the things that we actually want. In fact, say “no” to all the things you aren’t saying “F#$% YES!” to. Read this article for more information.

2) Re-examine your relationships. Who doesn’t make you feel good? Who makes you doubt yourself? Who do you feel will reject you if you act like your true self around them? Gracefully begin to distance yourself from these relationships. You might feel lonely for some time, but loneliness is sometimes a good thing.

3) Clear out your junk. Get rid of everything you don’t use, don’t like and don’t need. Marie Kondo, in the Life-changing Magic of Tidying Up, tells us to donate, trade, sell or dispose of everything we own that doesn’t bring us joy. I think that that is a wonderful litmus test to decide what we should be holding on to. Personally, one thing that did not bring me joy was an awful old desk in my room. It was uncomfortable and ugly. I replaced it with a free desk someone I knew was throwing away. I also donated 7 garbage bags of things: books, clothes and keepsakes from when I was a child. Since then, I feel like my room has been infused with a little bit more joy. Remove all your joyless items from your life and observe how your energy changes.

4) Sit in silence. This could be meditation, staring at the wall, chanting or simply breathing. Do it with eyes closed or open. I start at 20 minutes of meditation—a meditation teacher I had told me to always use a timer to increase self-discipline—and work up to 30 some days and an hour on really good days. Start with 5 minutes. Sitting in silence helps to quiet the mind and bring us back to the present. You’ll be amazed at what you discover when you sit in silence. Read some books on meditation or take a meditation course for specific techniques, but simply sitting in silence can offer amazing benefits as well.

5) Explore the topics that interested you as a child. When I got back into painting in 2008, after getting a science degree when I’d always been interested in the art, my life changed a little bit. I started a blog in 2011; it happens to be the one you’re reading now. Get back into whatever you were passionate about as a child, even if it’s just a cartoon you used to watch.

6) Start a gratitude jar. Once a day write down something that you are grateful for—use as much detail as possible—and toss it in a jar or shoebox. When you’re feeling low, open up the jar and read the messages you’ve left yourself. I also tried a similar exercise with things I wanted to manifest or achieve. A few months later I read my entries and realized I’d achieved every single one. It’s amazing what kind of energy glass jars can attract.

7) Read. According to James Altucher, you need to read 500 books on a given topic in order to become an expert on something. You have 5 years to reinvent yourself, so start your reading now. Read one book and then, from that book, read another. It’s interesting where reading trails can lead us. I read one book, which mentions another book, read that book and then end up in a new world I never knew existed. I personally feel a little anxious when I don’t have a book beside my bed, but if you’re new to reading, start small. There are two books that I’ve already mentioned in this blog post; start from either of them and then go from there. The next on my list is The Artist’s Way, by Julia Cameron, which was mentioned in The Power of No. Who knows where that one will lead me.

8) Get 8-9 hours of sleep a night.

9) Eat your vegetables, especially leafy greens. Avoid sugar, moderate alcohol and caffeine. Eat healthy protein and healthy fats (if you don’t know what those are, welcome to my blog! browse more of my articles on healthy eating or book an appointment with a naturopathic doctor like me!—shameless self promo).

10) Exercise. Enjoy some movement every day.

11) Exercise your idea muscle. According to James Altucher, creativity is a muscle that we need to exercise lest it atrophies, like any other muscle. He recommends getting a journal and writing 10-20 ideas in it every day. They don’t have to be good ideas, just any ideas. Removing the filter of self-judgement is important for allowing creativity to flourish. We need to strengthen that muscle.

12) Get some psychotherapy. Start dealing with childhood wounds and meeting your inner critic. Address your erroneous beliefs about yourself, the world and the past. Contact me to learn where to get quality psychotherapy in Toronto at an affordable price.

13) Expand your social circle. If you find that after following step 2 your social circle has gotten smaller, start to find ways to expand it. My favourite way to reinvent my social interactions, and thus begin to reinvent my life, is to look up a meetup.com group and start attending. If you’re not sure about a meet-up group you’ve attended, give it 2 more tries before deciding not to go back. In 3 tries, you’ve either made new friends and connections or decided that the energies of the group aren’t right for you. Online dating is another cool place to start meeting people outside your social sphere and getting over social anxieties.

14) Establish a self-care routine. What would someone who loved themselves do every day? Try to do at least some of those things every day. It could be going for a 15-minute walk before doing the dishes. It could be doing the dishes rather than leaving a messy kitchen for your more tired future self. Think about what things will make you feel good and then do them. Most of the time this involves bubble baths—light some candles while you’re at it. Read this article on self-care to learn more.

15) Write a Have-Done List. Instead of writing a list of things you have to do today—your standard To-Do List—write a list of things you’ve done at the end of every day. This fills people with a sense of accomplishment from looking at everything they’ve done. It definitely beats the stress and anxiety of looking at the list of things that must get done looming before them.

16) Treat other people as if it were their last days on earth. We’ve all been told to “live each day on Earth as if it were your last.” But what if you lived as if each day on Earth were everyone else’s last? You’d probably treat them a little more nicely, be open with them, be honest with them and not gossip or speak badly about them. You might appreciate them more. The idea is James’, not mine, but I like it. I think it’s a good rule for how to treat people.

17) Pay attention to what you’re jealous of and what you despise in others. The things we are jealous of in others are often our disowned selves. If I’m jealous of my friend’s Broadway debut I’m probably disowning a creative, eccentric and artistic side of myself that it’s time I give love and attention to. The things we’re bothered by in others often represent our shadow sides, the negative things we disown in ourselves. I used to tell myself the story that my ex-boyfriend was selfish; he took care of his needs first. However, maybe I just needed to start taking care of my own needs or come to terms with my own tendencies towards selfishness. Our negative emotions in relation to others can provide us with amazing tools of enlightenment and prime us well for our own personal reinventions.

18) Let go of the things that were not meant for you. Past relationships, missed opportunities, potential patients that never call back, “perfect” apartments, etc. Say good-bye to the things you don’t get. They’re for somebody else. These things are on their own journeys, as you are on yours. If you miss one taxi, know that there are other, probably better, ones following it. So, rather than wasting time chasing after the missed taxi, meditate on the street corner until the next one comes along.

19) Listen. Ask questions. Show curiosity. When someone finishes speaking to you, take a breath and count to 2 before responding. It’s amazing how your relationships change when engaging in the simple act of listening. I love the Motivational Interviewing technique of reflective listening. In reflective listening, we repeat back the other’s words while adding something new that we think they might have meant, looking for the meaning between the person’s—your friend’s, patient’s or client’s—words. I find that this has helped the person I’m speaking with feel truly listened to. If I get the meaning wrong, it gives the other person a chance to correct me and thereby ensure that we’re really communicating and understanding each other. This one simple tool—reflective listening—has transformed my naturopathic practice and interviewing skills.

20) Be patient. Personally, I’m terrible at this. But, like you, I’ll try working on the other 19 steps while I wait for the next stage of reinvention to take hold. I’ve ordered my next book from the library. See you all in 4 years.

Gratitude Journal Part 2

I’m grateful for endings

that merge into new beginnings,

karmic cycles and their painful lessons

and excruciating yearly rituals that often end

in transformations.

 

I’m grateful for long late-night horizontal conversations

tiny loving gestures

unity

and the Universe announcing her timing

loud and clear.

 

For experience.

 

For strength and resilience

reflected

in the mirror.

 

For friends and family who linger

around the corner

ready to reemerge

when you call them.

 

For cold winter winds that bring loss

and change

and propel us on.

 

For memories that needn’t be analyzed;

they’re simply gifts to cherish and remember.

 

The winter winds push us

on through the frigid night

into spring.

Listening to My Body (and why my pants are too tight)

Listening to My Body (and why my pants are too tight)

New Doc 7_5I am in my grade 12 photography class. I am 17 years old. I have my head on the desk in abject despair, as I succumb to the intense stress that was my last year of high school, where every academic move I made would dictate my future. I remember catching sight of my thighs nestled on the hard-backed plastic chair beneath the desk. And, although my struggles in that moment were seemingly unrelated to my body, I remember feeling a sense of satisfaction as I made a mental note of how the once-curvy lines of my thighs were straightening themselves out, flattening and loosening some of the fat that cushioned my thigh bones. From this satisfaction, I drew a sense of calm; I was losing weight, therefore things would be all right. The notion sounds ridiculous now but, at the time, I associated thinness with all the things I valued: friendship, love and even success. These things could only take place in someone inhabiting a thin body. I would, naturally have to complete the prerequisite of achieving “thinness” before I could have any of those things. This belief, rather than creating a connection between the rest of my life and my experience in my body, only served to fragment my bodily experience, as I tried to form my shape into the mould I thought it should inhabit.

Fast-forward more than 10 years later. There is a sale at a store I used to frequent as a teenager. Since all my jeans have the coordinated foresight to spring holes at the same time (between the thighs, naturally), I decide to go in and try on some pants. When I realize that I take a full two sizes smaller than the last time I ever slid this brand of jeans over my hips, my chest is filled with the same contented bubbling I experienced that afternoon in photography. The anxiety of my future – my career, my empty wallet and my relationship -relaxes. I walk out with two pairs.

I am wearing the jeans on the subway when I run into my former boss. She and I chat about the weather and the school and she tells me that her young daughters refuse to wear pants because “they encumber their knees at circle time.” We chuckle at the humor of the situation and my mind travels to my closely wrapped thighs, feels the snugness of denim surrounding them. For me, pants serve as a container for the flesh that threatens to spill out of them. I remember wondering when my definition of “comfort” evolved from the freedom of the body to expand, move and breathe to this feeling of secure confinement I experience inside my jeans. I doubt these pants would allow my knees to properly stretch themselves out and bend at circle time. Luckily, when you’re pushing 30, you get to sit in chairs while people tell you stories.

As a naturopathic doctor, I preoccupy myself with the relationship our bodies have with our environment and lifestyles: how do the products we use affect our hormones? How does the food we eat and the movement we engage in affect our internal terrain? How does our mindset prevent disease? What I often don’t ask is how the learned relationship one has with their body affects health. Does the way I view my lower body cause me to engage in behaviours that affect my health? How are my tight jeans impeding lymphatic flow? How do they affect my digestion? Does my sense of self-worth affect my blood sugar? The answer is it absolutely can, if my sense of self-worth causes me to ignore my body’s food cravings and hunger signals. The way we treat ourselves and imagine our own health stems from our relationships with our bodies, which in turn dictates our future health states.

Susie Orbach, a feminist psychotherapist and author, once wrote that female babies are breastfed for less time, and picked up and cuddled less than male babies. She goes on to describe how this early treatment of women, “characterized by emotional deprivation and feelings of unentitlement”, secures the female’s place as a second-class citizen in society. More than that it teaches women to disconnect with our bodies. If our needs are not met at an early age, we are led to believe that these needs are wrong. We are taught to ignore the smelling, farting, bleeding, overflowing, curving bodies we are born with and try to recreate a “false body” that is perfect and that begins to believe it is “comfortable” being squeezed and starved and stuffed into pointy-toed shoes. Or we simply develop the ability to de-identify with the discomfort. This mechanism can lead to injury or disease if we fail to truly listen to what our bodies are trying to alert us to. (Matthew Remski writes about this extensively in his amazing research project on yoga injuries called What Are We Actually Doing in Asana (WAWADIA). I’ve been devouring his articles this week).

Orbach goes on to theorize that the symptoms the body produces in a disease state just might be a cry for help; the body is attempting to insist on its existence, to demand to be heard. So what then are menstrual cramps? Are they simply a result of inflammation or a hormonal imbalance caused by lifestyle or are they attempts made by the body to cry out, “I am female! I am menstruating! I am in need of attention!”

I remember a patient I had who would deny herself life pleasures. Convinced she needed to lose weight, she would ignore her hunger signals, even proudly telling me that she would turn to her stomach and tell it to “shut up” when the grumbling became too loud. Her chief complaint was chronic pain. I wonder if her body’s pain was simply its way of telling her it existed. I wonder if she’d have found a way to sufficiently answer her stomach’s calling, the pain would have subsided. Perhaps by listening to the experience of our bodies we can start to properly take care of our health. We can start by wearing comfortable pants that don’t “encumber the knees”, moving naturally, embracing our sexual appetites, feeding ourselves the food we truly crave and answering the need for physical touch and rest.

In a society that tends to view the body as an object, a machine that sometimes gets jammed with inconveniences such as pain, menstrual issues and eczema, I wonder how our collective health would change if we began to experience the body as a tool for healing and self-growth – something inherently wise.

To share one last story, I remember sitting across from Teresa, our school counsellor, while I was still a naturopathic student. At the time I was deciding to break up with my then-boyfriend thereby ending a 5-year relationship. I told her I had never been clear on the difference between the fear and apprehension that came with seizing something good and the repulsed feeling of avoiding something bad. This has led me to make decisions in my life that weren’t necessarily right for me. She asked me to cultivate the two feelings and locate their positions in my body. “See if there is any difference,” She told me. As I tuned in I immediately noticed that fear was closer to my heart. It was higher up and it bore the faint pleasant glow of excitement behind its initial anxiety. Disgust was located lower down. It felt like a stomach ache, a sense of doom, of indigestion: a hard-to-digest truth. It was in this moment that I fully appreciated the body’s wisdom. The old adage “listen to your gut” began to ring true to me. My gut was sending me a message that was loud and clear, but it was up to me to listen to it.

So what are some exercises we can do to cultivate body awareness and re-inhabit our bodies? 

– Practice regular body scan mediations, such as those prescribed by the Mindfulness-Based Stress Reduction (MBSR) model taught by Jon Kabat-Zinn.

– Try Susie Orbach’s “Mirror Exercise” in her book Fat is a Feminist Issue or spend 3 minutes a day for 21 days staring at a body part that you have a hard time identifying with. By staring at the nose you’ve always felt was too big on a regular basis, you are able to incorporate it into your sense of self and accept it as something beautiful, in the way you would come to love the same nose on your grandfather, daughter or dear friend.

– Set a timer every hour while at work to remind yourself to tune in to your body and your breath. Notice your feet planted on the floor and move your awareness up through your feet to the top of your head. Ask yourself if there’s anything your body needs: are you thirsty, hungry, bored or lonely? Do you need to stand up and stretch? Do you need a hug?

– Get regular acupuncture or constitutional hydrotherapy to help the flow of Qi through the body.

– Finally, touch yourself. Practice ayurvedic self-massages or apply a natural moisturising lotion or oil before bed. Practice self-care in the form of hydrotherapy. Even placing the hands over the heart and breathing into that area will help to release oxytocin, a hormone responsible for love and bonding, creating feelings of calmness and attachment to the physical body.

21 Days to Happiness

21 Days to Happiness

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I recently came across this Ted Talk, by Shawn Anchor, recommended by a fellow student. The insightful, well-delivered, entertaining talk is important in the field of naturopathic medicine because it stresses the importance of positivity for living a life of health and happiness. 

[youtube=http://www.youtube.com/watch?v=GXy__kBVq1M]

Shawn expresses the idea that only 10% of our inner happiness is due to external factors: our job, possessions, education, etc, while the other 90% is attributed to how we perceive those circumstances. We live in a society where we focus on reaching goals, thinking that once we reach those goals we will be happier: “When I lose 20 pounds, I’ll feel happy with myself,” “When I get that raise, I’ll like my job,” or “If I get into that school, then I’ll feel great.” It reminded me of a story our Mindfulness Based Stress Reduction teacher told us on Tuesday night:

There was once a fisherman, sleeping in his boat. He had caught all his fish for the day and so he was enjoying the sunny afternoon by taking a well-deserved nap, when along came a businessman.

“What are you doing?” Asked the businessman.

“I’m resting.” Replied the fisherman, “I’ve caught all my fish for the day.”

“Why don’t you go out and catch more?” Asked the businessman.

“Why would I do that?” Wondered the fisherman.

“Well, if you went out and caught more fish, you’d make more money.” Stated the businessman, as if it were the most obvious thing in the world.

“What would I do with more money?” Inquired the fisherman.

“You could buy a bigger boat.”

“And what would I do with a bigger boat?”

“Well,” replied the businessman, “You could catch even more fish, then. Then you could make even more money, buy a fleet of boats, employ other fishermen, catch even more fish and make even more money.” He finished, seeming pleased with his insightful advice.

“And what would I do then?” Asked the fisherman, who by now was very confused.

“Well,” exhaled the businessman, on a role now, “then you could really enjoy life!”

The fisherman looked at his beautiful surroundings, the afternoon sun dancing on the calm waters of the harbour; his humble but comfortable boat serving as the perfect place to rest. He looked back up at the businessman, who by now was looking quite triumphant, and replied,

“And what the heck do you think I’m already doing?”

Like the fisherman, being content with your life’s present circumstances is the key to increased enjoyment and satisfaction. According to Shawn Anchor, becoming more positive isn’t hard: he proposes a way to increase your satisfaction and overall happiness by spending only 2 minutes a day for 21 days in a row.

He suggests a list of activities that one might engage in, including exercise, meditation or journalling. One of the activities that stood out for me is expressing daily gratitude by taking 2 minutes at the end of each day to journal 3 things you have been thankful for in the past 24 hours. According to Shawn, this simple task is enough to set the brain on a different path, one that leads to increased happiness.

I often find that, in my life, I spend my time focusing on my goals and aspirations for the future. While this striving for future goals is what I’ve been taught to do in order to experience successes in my life, it results in my inability to pay attention to and enjoy my life in the present. Changing my lens of focus to the life blessings I have now allows me to marinate in the present. I find that, while it may takes some time to shift my gaze to the things I already have, rather than the things I’d like to have, once I got started, it was hard to stop at just listing three things. I felt like I wasn’t doing my life justice by excluding the numerous gifts I’m given on a daily basis.

I also like the idea of putting these pieces of gratitude on small pieces of paper and storing them in a glass jar in a visible place. At the end of the month, or during a bad day, I open my jar and pull out a few pieces of gratitude, reminding myself how charmed my life actually is, and thus rewiring my brain to truly appreciate and enjoy it.

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