by Dr. Talia Marcheggiani, ND | Feb 23, 2016 | Art, Art Therapy, Balance, Culture, Digestion, Docere, Education, Emotions, Finding yourself, Happiness, Healing Stories, Health, Letting Go, Lifestyle, Listening, Love, Medicine, Meditation, Mental Health, Mind Body Medicine, Mindfulness, Naturopathic Philosophy, Naturopathic Principles, Patience, Philosophy, Psychology, Reflections, Self-care, Self-reflection
Today, 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.
- 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.
- 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.
- 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.
- 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.
- Letting go is one of the most important life skills for happiness. So is learning to say no.
- 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.
- Patience is necessary. Be patient for your patients.
- 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.
- 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.
- 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.
- 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.
- 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.
- Self-care is not selfish. In fact, it is the single most powerful tool you have for transforming the world.
- Why would anyone want to anything other than a healer or an artist?
- Getting rid of excess things can be far more healing than retail therapy. Tidying up can in fact be magical and life-changing.
- It is probably impossible to be truly healthy without some form of mindfulness or meditation in this day and age.
- 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.
- 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.
- 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.
- 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.
- 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.
- Do no harm is a complicated doctrine to truly follow. It helps to start with yourself.
- Drink water. Tired? Sore? Poor digestion? Weight gain? Hungry? Feeling empty? Generally feeling off? Start with drinking water.
- 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.
- 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.
- 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?
- “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.
- 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.
- 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.
- 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!
by Dr. Talia Marcheggiani, ND | Nov 16, 2015 | doctor as teacher, Education, Emotions, Endocrinology, Healing Stories, Hormones, Listening, Medicine, Meditation, Mind Body Medicine, Naturopathic Philosophy, Preventive Medicine, Reflections, Women's health, Writing
Premature Ovarian Failure no longer bears that name. It’s not a failure anymore, but an insufficiency. POF becomes POI: Premature Ovarian Insufficiency, as insufficiency is apparently a softer term than “failure”. For me, it’s another telling example of how our society fears the names of things, and twists itself into knots of nomenclature and terminology rather than facing pain head-on. In this case, the pain is derived from the simple fact that the ovaries do not respond to hormones, that they for some reason die at an early age and cause menopause to arrive decades before it’s due, leading to infertility and risk of early osteoporosis.
Insufficiency, for me at least, fails to appease the sensitivity required for naming a problem. It reminds me of a three-tiered scoring system: exceeds expectations, meets expectations, insufficient performance. These reproductive cells have not been up to task. They’ve proven to be insufficient and, in the end, we’ve labelled them failures anyway—premature ovarian disappointments. Our disdain for the bodies we inhabit often becomes apparent in medical jargon.
What expectations do we have for our organs, really? For most of us that they’ll keep quiet while we drink, stay up late and eat what we like, not that they will protest, stop our periods, make us itch or remind us that we are physical beings that belong here, to this earth, that we can sputter and shut down and end up curb side while we wait for white coats to assist us. Our organs are not supposed to remind us of our fragile mortality. When it comes to expectations overall, I wonder how many of them we have a right to.
In one week I had two patients presenting with failures of sorts. With one it was her ovaries, in another it was his kidneys, first his left, now his right. Both of them were coming to me, perhaps years too late, for a style of medicine whose power lies mainly in prevention or in stopping the ball rolling down the hill before it gains momentum. When disease processes have reached their endpoint, when there is talk of transplant lists and freezing eggs, I wonder what more herbs can do.
And so, when organs fail, I fear that I will too.
In times of failure, we often lose hope. However, my patients who have booked appointments embody a hope I do not feel myself, a hope I slightly resent. In hope there is vulnerability, there is an implicit cry for help, a trust. These patients are paying me to “give them a second opinion”, they say, or a “second truth”.
I feel frustration bubble to the surface when I pore over the information I need to manage their cases. At the medical system: “why couldn’t they give these patients a straight answer? Why don’t we have more information to help them?” At my training: “Why did we never learn how to treat ovarian insufficiency?” At the patients themselves: “Why didn’t he come see me earlier, when his diabetes was first diagnosed?” And again at the system: “Why do doctors leave out so much of the story when it comes to prevention, to patient power, to the autonomy we all have over our bodies and their health?” And to society at large: “Why is naturopathic medicine a last resort? Why is it expensive? Why are we seen as a last hope, when all but the patients’ hope remains?”
Insufficiency, of course, means things aren’t enough.
I feel powerless.
There is information out there. I put together a convincing plan for my patient with kidney failure. It will take a lot of work on his part. What will get us there is a commitment to health. It may not save his kidneys but he’ll be all the better for it. My hope starts to grow as I empower myself with information, studies some benevolent scientists have done on vitamin D and medicinal mushrooms. Bless them and their foresight.
As my hope grows, his must have faded, because he fails to show for the appointment. I feel angry, sad and slightly abandoned—we were supposed to heal together. Feelings of failure are sticky, of course, and I wonder what story took hold of him. was it one that ended with, “this is too hard?” or “there is no use?” or “listen to the doctors whose white coats convey a certainty that looks good on them?”
A friend once told me, the earlier someone rejects you, the less it says about you. I know he’s never met me and it’s not personal, but I take it personally anyways, just as I took it personally to research his case, working with a healing relationship that, for me, had been established since I entered his name in my calendar. In some way, like his kidneys, I’ve failed him. Since we’re all body parts anyways, how does one begin to trust another if his own organs start to shut down inside of him? Why would the organs in my body serve him any better than the failing ones in his?
I get honest with my patient whose ovaries are deemed insufficient (insufficient for what? We don’t exactly know). I tell her there aren’t a lot of clear solutions, that most of us don’t know what to do–in the conventional world, the answer lies mainly in estrogen replacement and preserving bone health. I tell her I don’t know what will happen, but I trust our medicine. I trust the herbs, the homeopathics, nutrition and the body’s healing processes. I admit my insufficiency as a doctor is no less than that of her ovaries, but I am willing to give her my knowledge if she is willing to head down this path to healing with me. Who knows what we’ll find, I tell her, it might be nothing. It might be something else.
It takes a brave patient to accept an invitation like the one above; she was offered a red pill or a blue pill and took a teaspoon of herbal tincture instead. I commend her for that.
There aren’t guarantees in medicine but we all want the illusion that there are. We all want to participate in the game of white coats and stethoscopes and believe these people have a godlike power contained in books that allows them to hover instruments over our bodies and make things alright again. Physicians lean over exposed abdomens, percussing, hemming and hawing and give us labels we don’t understand. The power of their words is enough to condemn us to lives without children, or days spent hooked up to dialysis machines. We all play into this illusory game. They tell us pills are enough… until they aren’t. This is the biggest farce of all.
I can’t participate in this facade, but I don’t want to rob my patient of the opportunity for a miracle, either. We share a moment in the humility of my honesty and admission of uncertainty. I know my patients pay me to say, “I can fix it.” I can try, but to assert that without any degree of humility would be a lie. How can one possibly heal in the presence of inauthenticity? How can one attempt to work with bodies if they don’t respect the uncertain, the unknown and the mysterious truths they contain? In healing there is always a tension between grasping hope and giving in to trust and honestly confessing the vulnerability of, “I don’t know.”
For my patient I also request some testing—one thing about spending time on patients’ cases and being medically trained is that you get access to information and the language to understand it. I notice holes in the process that slapped her with this life-changing diagnosis.
When her labs come back, we find she might not have ovarian insufficiency after all. Doorways to hope open up and lead us to rooms full of questions. There are pieces of the story that don’t yet fit the lab results. I give her a list of more tests to get and she thanks me. I haven’t fixed her yet, but I’ve given her hope soil in which to flower. I’ve sent her on a path to more investigations, to more answers. And, thanks to more information in the tests, I’ve freed her and her ovaries from the label of “failure” and “insufficient” and realized that, as a doctor, I can free myself of those labels too. The trick is in admitting, as the lab results have done in their honest simplicity, what we don’t know.
For the moment, admitting insufficiency might prove to be sufficient in the end.
by Dr. Talia Marcheggiani, ND | Aug 30, 2015 | Acupuncture, Addiction, Community, Healing Stories, Health, Human Rights, Listening, Medicine, Mental Health, Motivation, Philosophy, Politics, Psychology, Volunteering
I was recently told that a benefactor would contact me about the work I’ve been doing for the Evergreen Yonge Street Mission in Toronto—I provide naturopathic services to street-involved youth twice a month in the drop-in health clinic. There is a natural health company that might be interested in sponsoring some of the naturopathic services. However, in order to understand where their money is going, they want to hear some success stories before they consider if and how much to donate. Are the services working? They want to know. Since I, more than anyone, appreciate the power of a story and, since I’m trying to raise some money to expand the services I provide myself, I thought I’d tell one. Names and details have been changed.
—
A shift at the mission lasts a few hours. Youth sign up for the adolescent medicine specialist and her Sick Kid’s Hospital resident, dental work or me, the naturopath, represented under the heading “naturopathic medicine/acupuncture”. There is no money for supplements—and supplements can be expensive—and the youth I treat don’t have money to buy food let alone a bottle of melatonin. So I do acupuncture.
Eduardo was waiting when it I called him. He was lying face up on the bench in the waiting area, looking at a pamphlet on “dope addiction”. He was wearing sunglasses. When he came into the visit, he didn’t take them off, despite the low-level lighting of the treatment room I occupy. It felt strange to talk to someone’s dark glasses, not making eye contact with them as we spoke. I wondered vaguely if I should tell him to take off the glasses, and then left it alone—his comfort as the patient should take priority over mine. Why challenge his autonomy and further push the power imbalance by telling him to do something that was not fully necessary? I worked around the glasses, moving them aside slightly in order to needle the acupuncture point yin tang, located between the eyebrows. The glasses stayed on. So be it.
Eduardo and I spoke Spanish, as his English wasn’t strong. He spoke of feeling shaky, showing me his tremoring hand to prove it. When did the shakiness start? I inquired. When I overdosed on crack, he explained. Well, that would do it, I thought to myself, although you can imagine my clinical experience with crack overdose was limited—there aren’t that many crack overdoses in Bloor West Village.
As it turned out, Eduardo had a significant dependence on marijuana, smoking 7 grams a day while in his home country. When he bought pot on the streets in Toronto, however, he found one deal laced with crack. He ended up in the hospital after smoking it. Another time, his weed was laced with meth.
He held his hand up. I watched it shake. He told me his whole body felt shaky. This would be exacerbated further if he stopped smoking marijuana, he assured me. Had he ever stopped before? I asked. Yes, he said. Why did he stop? I asked him, taking a de-centred approach while staying curious about preferred ways of being. In this case I suspected he preferred to be sober—after all, something had made him stop.
The cost, he explained.
Ah, that, I thought. Well, it makes sense.
Any other reason? I asked him.
He explained that his family didn’t approve. I asked him why. What might they think of marijuana? What did they see him do when he was high that led to their disapproval. Eduardo couldn’t answer. He changed the subject and explained he’d gone back to weed after quitting it that time because it helped him sleep. Since the episode with the crack overdose, though, sleep was difficult. That’s why he was here: to get acupuncture to help with sleep.
Eduardo spoke in a low voice, often responding with a word or two. Despite the glasses shielding his eyes, he kept his gaze on the floor. When I had him lie on the treatment table, I encouraged him to close his eyes and rest while the acupuncture worked.
After a few minutes, I removed the needles. He thanked me shyly and left. Like many of the people I treat, I figured the odds were high I’d never see him again.
—
I was surprised, then, that a month later, I saw him in the waiting area again.
The visit went pretty much the same way as the first with one key difference. The second time he came in, Eduardo removed his glasses, meeting my eyes for the first time.
I was touched.
His sleep was still bad. His mood was still low. He hadn’t smoked crack for a while. He was living in a shelter; his family had kicked him out because of his addiction to marijuana. He implied great trauma in his home country, however he didn’t say much more about it. He mentioned regretting that his English was poor—it had been traumatic to come to Canada.
He told me he was applying for medical marijuana. It would be a safer way to smoke, he told me.
He was practicing harm reduction on himself. I asked him if he considered this “taking steps.” He nodded. I asked him about any other steps he’d been considering. He mentioned swimming. Swimming had been a passion of his in his home country. I got more details about his goals: how often did he want to swim? Where? He decided that 3-5 times a week at the local pool would be ideal. I asked him what he’d first have to do to make that happen. Check the pool times, he answered.
I asked him if he’d ever considered quitting marijuana. He said no, he needed it to sleep and to manage his anxiety. But, you know, it was expensive. And, of course, he repeated, his parents had an issue with it. That was a problem for him. I asked him why it was a problem.
It’s a problem… he repeated. He said nothing more.
We did more acupuncture. He went on his way.
—
Two weeks later, Eduardo came to see me again. He took his glasses off as soon as he saw me.
He reported his sleep was better. He had been swimming 3 times a week at the local pool. He hadn’t smoked crack in a month. He’d stopped marijuana the last time he saw me. He hadn’t smoked for two weeks. He showed me his hand. It wasn’t shaking.
Do you think these are positive developments? I asked him.
He shrugged nonchalantly but failed to disguise the smile that tugged at the corners of his mouth. He looked down.
I put in some acupuncture needles and asked him what his next steps might be. He answered that he thought he might call his old boss back and get back to work. Then he wanted to save money so he could move out of the shelter he was in.
He then started to talk a little bit about his brother who was killed in his home country and his friends who’d betrayed him to another gang resulting in him having to flee for his life. He talked about receiving premonitions in his dreams. This made sleep difficult, but it had also caused him to act and avoid harm—he’d learned from a dream that his friends were untrustworthy. We wondered together if this was more than a source of anxiety, but a special skill that kept him safe. Maybe he wouldn’t have to be vigilant if important warnings came to him in his dreams. I wondered if marijuana, along with helping hims sleep had hindered that gift. He thought about that for a while.
When he left he asked me how many more acupuncture treatments he might need. I told him to come in as often as he liked but 8-10 was a good starting point.
Ok, he said, it’s been 3 so far.
Right, I said. It’s been 3.
Ok, he said. See you in two weeks.
He put his glasses back on and walked out into the chaos of Yonge Street. There was a street festival going on.
—
At one point in my time spent with Eduardo, one of the staff at the mission inquired about his mental capacities. Apparently the psychiatrist he’d been working with was considering a diagnosis of mental retardation or severe learning disability–it was taking him so long to learn English and he was often slow to answer questions.
No disrespect to psychiatry: the more I work with mental health, the more respect I have for the utility, albeit limited, of psychiatric assessments and medications. For many people, and when applied delicately and sensitively, these things add powerful meaning and serve as important life savers. However, I want to emphasize the importance of lowering practitioner power, understanding the challenges another person may face in their life and respecting the autonomy, decision-making power and special skills of the individual who seeks health care. In addition, rather than looking for the problem in the person, what success stories are they bringing forth? What goals have been set and what steps have been taken already?
I often comment that the stories I hear and the conversations I have in the work I do are not the least bit depressing. Sure, the youth have dark, complicated, often horrific pasts. However, every individual is a collection of hopes, dreams, goals and personal strengths and abilities. Every person that comes to see me wants something more for themselves and has already exercised an ability to move closer to their preferred ways of being in the world, showing me the incredible capacity for human strength and endurance. The only difference, between the perspective I get to enjoy and the one seen by other health professionals, however, is that I look for stories of strength. Because strength is always there, waiting for a thoughtful question to bring it into the light.
To contribute to the Yonge Street Mission naturopathic services and for more information on the campaign, please click here. Donations are made in USD.
by Dr. Talia Marcheggiani, ND | May 24, 2015 | Art, Balance, Canadian College of Naturopathic Medicine, Creativity, Education, Exercise, Family, Finding yourself, Happiness, Healing Stories, Health, Ideal You, Letting Go, Listening, Medicine, Meditation, Mental Health, Mind Body Medicine, Mindfulness, Motivation, Patience, Personal, Psychology, Relationships, Self-care, Self-reflection, Stress
According 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.
by Dr. Talia Marcheggiani, ND | Nov 20, 2014 | Acupuncture, Balance, Beauty, Book, Chronic pain, Healing Stories, Listening, Mental Health, Mind Body Medicine, Mindfulness, Preventive Medicine, Psychology, Self-care, Self-esteem, Self-reflection, Weight Loss, Women's health
I 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.
by Dr. Talia Marcheggiani, ND | Apr 8, 2013 | Art, Art Therapy, Book Review, Canadian College of Naturopathic Medicine, Creativity, Empathy, Healing Stories, Listening, Naturopathic Philosophy, Naturopathic Principles, Philosophy, Psychology, Student, Writing
A classmate recently lent me a book that introduced me to the intriguing field of “narrative medicine.” The book is called Narrative Medicine: Honoring the Stories of Illness, written by Rita Charon, MD, an internist practicing in New York City. Narrative medicine combines the practice of medicine with simultaneously learning to recognize, absorb, interpret, and be moved by the stories of illness.
According to the book, the practice of narrative medicine builds empathy and compassion for patients by giving meaning to their experience through stories. It allows doctors to bear witness to the patients and their suffering and to enable those who are suffering to be heard, thus making their care more effective and, by virtue of the doctor’s presence and ability to testify to the patient’s pain, the pain is lessened somewhat.
The Need for Narrative in Modern and Natural Medicine
Rita writes, “the medical impulse toward replicability and universality has muted doctors’ realization of the singularity and creativity of their acts of observation and description.” In medical school we come to learn that, when asked to choose between a) b) c) d) or e), all of the above, there can only be one right answer. Through these educative measures, we are led to believe that there is no room for creativity or individuality in medicine. Narrative medicine, however, begins to challenge that belief. According to Dr. Charon, there is a struggle in medicine to balance the need to properly observe the phenomenon of the individual patient and his or her particular clinical presentation before us, with the need to fit people into diagnostic categories. Oftentimes, the scale tips to the latter, simply by nature of patient volume or ease of the encounter. When we fit people into categories we can ease the anxiety that comes with uncertainty. We are soothed by the security of being right, the same way we are soothed by correctly choosing c) on a multiple choice exam. Patients, however, have come to resent this aspect of modern medicine. Rita writes, “patients complain that doctors or hospitals treat them like numbers or like items on an assembly line. They lament that their singularity is not valued and that they have been reduced to that level at which they repeat other human bodies.” In Rita Charon’s eyes, however, we are beginning to see a new emergence of both doctors and patients taking back the right to patient individuality in medical care. We naturopathic doctors hear this often, when asking why a patient decided to come to see us in lieu of a medical doctor, and hearing that they were driven by the need to be treated “like a person”, not just a disease.
Our bodies and our health are integral parts of the narratives of our lives. And so a personal medical history that, in the case of a medical school exam, takes about 8-10 minutes to complete, actually carries in it the patient’s life story. Everything that the body have been through the self has also been through and whatever has happened to the body remains ingrained in the self and forms a part of the patient’s narrative. Kathryn Montgomery, a colleague of Rita Charon’s once said, “you can accomplish an entire medical interview by simply asking a patient, “tell me about your scars.'”
Dr. Rita Charon writes, “without doubt, the teller and the listener in the clinical setting work together to discover or create the plot of their concerns. The better equipped clinicians are to listen for or read for a plot, the more accurately will they entertain likely diagnoses and be alert for unlikely but possible ones. To have developed methods of searching for plot or even imagining what the plot might be equips clinicians to wait, patiently, for a diagnosis to declare itself, confident that eventually the fog will rise and the contours of meaning will become clear.” Narrative, we learn, is essential for understanding illness.
Receiving a Patient History
Sir Richard Bayliss, another colleague of Charon’s, writes, “not only must the physician hear what is said but with a trained ear he or she must listen to the exact words that the patient uses and the sequence in which they are uttered. Histories must be received, not taken.”
Rita Charon’s current method of “receiving” a patient history is described eloquently in her book. It differs so much from the style we are taught in medical school, that I feel it is worth sharing. She writes that, when she first meets a patient, she begins by saying, “tell me what you think I should know about your situation.” She then makes the commitment to listen, without speaking or writing anything down. In medical school we are taught to organize a chart by history of presenting illness, past medical history, family history, etc. However, Charon realized that, by allowing the patient to direct his or her own clinical interview, the information all comes out eventually. She believes it is crucial to allow the patients to narrate their own history, allowing the information to take its own order, to formulate itself into not just a coherent plot but also a literary form, so that the entire story becomes apparent, and free from her own bias and internal or external editing. While the patient tells his or her story, Dr. Charon listens as intently as she can, registering diction, form, images and the pace of speech emitted from the patient’s mouth. She tries not to interrupt or confer signs of encouragement, pleasure or disapproval. She refrains from asking questions. And, she takes the time to absorb the metaphors, idioms, accompanying gestures, plot and characters involved in the patient’s narrative.
Once her patient has finished with his or her telling, Dr. Charon proceeds to the physical exam portion of the clinical visit. She tries to capture what has been said by writing the story down in her chart while the patient changes into his or her gown and readies for the physical examination.
Dr. Charon writes that it has taken her a while to perfect this form of receiving a patient history. As unorthodox as it may seem, she writes that she has come to thoroughly enjoy the individuality and humanity of the stories that come from each person, each one so different from any other and each belonging to a singular person and body. It has helped her understand her patients, maintain empathy for them and provide them with what she believes is more effective care.
The Parallel Chart
Rita Charon believes that, not only is the use of narrative helpful for the doctor-patient relationship, it can be used to help physicians and other healthcare practitioners digest their experience as well. In one of her years as a clinical supervisor, she developed a practice called the Parallel Chart. As medical students and doctors, we are required to write our patient’s stories in the form of medical charts, following a specific format, creating what can be viewed as an entire literary genre used solely among medical professionals. Medical students and doctors alike are expected to learn to write and maintain a coherent medical chart, according to the standards of this genre.
However, as a clinical supervisor, Rita Charon also has her young precepts write a Parallel Chart, one that will not be filed for reference but that is just for the benefit of the practitioner, written in plain language, about one of his or her patients. She tells her students, “every day you write in the hospital chart about each of your patients. You know exactly what to write there and the form in which to write it. You write about your patient’s current complaints, the results of the physical exam, laboratory findings, opinions of consultants, and the plan. If your patient dying of prostate cancer reminds you of your grandfather, who died of that disease last summer, and each time you go into the patient’s room, you weep for your grandfather, you cannot write that in the hospital chart. We will not let you. And yet it has to be written somewhere. You write it in the Parallel Chart.”
After giving her students these instructions, Rita Charon meets with them in a group once a month and gives everyone the chance to read a Parallel Chart entry of their choice out loud. After the reading, she proceeds to comment on the genre, temporality, metaphors, structure and style of the text that has been written, using her literary background as a guide. The other students then have a chance to respond to the text, creating a dialogue surrounding their clinical experiences.
She reflects that her students in the past have written about their deep attachment to patients, their feelings of helplessness in the clinical encounter in their role as mere medical students, the rage, shame and humiliation they experience in the face of disease as well as their awe at patients’ courage. Dr. Rita Charon claims that the students who undertake the task of keeping a Parallel Chart have found that they are more in touch with their own emotions during the clinical encounter, feel deeper empathy for their patients and fellow colleagues and are able to understand their patients more fully. Research is even being conducted at Columbia University to evaluate the effectiveness of Parallel Charting, finding that physicians who engage in this practice are more proficient and effective at conducting medical interviews, performing medical procedures and developing doctor-patient relationships with patients.
In many ways, naturopathic medicine already acknowledges the importance of patient story-telling when it comes to healing from disease. We treat people as individuals and look for the root cause of illness, taking into account the story behind each of our patient’s “scars”. However, as our school curriculum becomes more medicalized and primary care-focused, I believe that our need to conduct efficient medical interviews and develop effective treatment plans is in danger of displacing our inherent philosophies. Taking the time to read Rita Charon’s book opened my eyes to the importance of patient individuality and respect for patient narrative. To understand illness, it is essential to integrate narrative into the framework of the clinical encounter by giving patients the space to tell, while also giving ourselves, the practitioners, the space for our own telling with the intention of becoming better, more empathetic doctors.
by Dr. Talia Marcheggiani, ND | Mar 26, 2012 | Ayurvedic Medicine, Balance, Canadian College of Naturopathic Medicine, Empathy, Finding yourself, Healing Stories, Home Remedies, Listening, Nature, Nature Cure, Naturopathic Philosophy
I can’t really say that I’m a creature of habit. I easily tire of routine and consistency. Maybe it was for this reason that I felt the need to take off from Canada for a few years and travel, why I remain a perpetual student (no two days are the same and we get a 4-month summer of something radically different). The student life serves me well in breaking up the routine.
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by Dr. Talia Marcheggiani, ND | Mar 8, 2012 | Art, Balance, Colombia, Culture, Empathy, Family, Healing Stories, Listening, Love, Naturopathic Philosophy, NGOs, Photography, Psychology, South America, Travel, Travel Stories, Volunteering, Volunteering Abroad
As mentioned before, naturopaths are not necessarily defined by our toolbox of modalities. What, then, does define us as a profession? As we witness a rise in the demand for complementary and alternative medicine, and with it, the rise in something called the “Holistic Medical Doctor”, what sets naturopathic doctors apart?
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