“There’s a sunrise and a sunset every day and you can choose to be there or not. “You can put yourself in the way of beauty.” – Cheryl Strayed, Wild Yellow and orange hues stimulate melatonin production, aiding sleep. Melatonin is not just our sleep hormone, it’s an antioxidant and has been studied for its positive mood, hormonal, immune, anti-cancer, and digestive system effects. Our bodies have adjusted to respond to the light from 3 billion sunsets. While we can take melatonin in supplement form, use blue light blocking glasses, or use red hued light filters and, while tech can certainly help us live more healthfully, it’s important to remember that the best bio-hack is simply to remember your heritage and put yourself back in nature’s way. The best tech of all is in the natural rhythms of the planet and encoded in your beautiful DNA. Optimal health is about re-wilding. Optimal health is about remembering who you are and coming back to your true nature. You have the code within in you to live your best, healthiest life. I believe healing is about tapping into that code, supporting our nature, and allowing the light of our optimal health template to shine through.
The proximity to water can improve focus, creativity, health and professional success according to marine biologist and surfer Wallace J. Nichols in his book, Blue Mind. A “blue mind” describes a neurological state of of calm centredness. Being around water heightens involuntary attention, where external stimuli capture our attention, generating a mind that is open, and expansive, and neurochemicals like dopamine and serotonin are released. He says, “This is flow state, where we lose track of time, nothing else seems to matter, and we truly seem alive and at our best”. Contrast a blue mind to a red mind, where neurons release stress chemicals like norepinephrine, cortisol in response to stress, anxiety and fear. From the book Mindfulness and Surfing:
“Surfing is not just about riding a wave, but immersion in nature: the aching silence of a calm sea is punctuated by a cluster of blue lines. The point is to spend a little more time looking and listening than doing.
“Maybe this is not just about being but about what the philosopher Heidegger called “becoming”–a being in time, an unfolding sense of what he further called ‘dwelling’.
“When we dwell, we inhabit.”
Jungian Psychoanalyst, Frances Weller posed the question, “What calls you so fully into the world other than beauty?” In other words, “Without beauty what is it that attracts us into life?” Our human affinity for beauty is perhaps the greatest pull of all into aliveness. And yet so many of us feel purposeless, or that life is meaningless. In our world we are suffering from a “Meaning Crisis”, which perhaps partially explains the epidemic of mental health issues that plague us. We spend so much time bogged down in the business of being alive: bills, chores, work–“dotting Ts and crossing Is” as I like say 😂 This is part of the reason why 1/6th of my 6-week Mental Health Foundations program (Good Mood Foundations) involves getting into nature. For there is nothing more beautiful than the gorgeous imperfection of the natural world. We are called by it. There are myriad scientific studies on the power of “Forest Bathing” for de-stressing, for mental health, for supporting our mood, hormonal health, immune systems, social relationships, and so on. And yet so often when we say words like “beauty” we call on images of “perfection”: symmetrical youthful faces, bodies with zero fat on them, etc.
We are focused on the missing parts instead of how the effect of nature’s imperfect beauty has on us–and thus we rob ourselves of the pleasure of being in the presence of beauty. For what is pleasure but beauty personified? And what is depression other than a lack of deep, embodied soulful pleasure? I find being in nature brings me closer, not so much to beauty as a concept of commercial idealism, but a sense of pleasure. It pulls me into my body.
I feel my feet on the ground, my breath timing my steps, the birdsong and wind in my ears, and I feel calmed, and centred, called into the experience of being fully alive.
If you’re struggling to find meaning, practice showing up to your sunsets for a few evenings in a row.
Put yourself in the way of beauty. When the sunsets show up everyday, will you show up too?
It was a crappy week and I was chatting with a friend online. He said something that triggered me… it just hit some sort of nerve. I backed away from my computer, feeling heavy. I went to the kitchen to pour myself a glass of water and collapsed, elbows on the counter, head in my hands, my body shaking and wracking with deep, guttural sobs.
A few seconds later, I’m not sure how long exactly, I stood up. Tears and snot streaming down my face, I wiped them off with a tissue. I felt lighter, clearer. I was still heavy and sad, but there was a part of me that had opened. I went back to my computer and relayed some of this to my friend, “what you said triggered me, but it’s ok, it just hit a personal nerve. I’m ok now though, I know you didn’t mean any harm”. I typed to him.
Joan Rosenberg, PhD in her book 90 Seconds to a Life You Love, would have said that, in that moment, I had been open to feeling the moment-to-moment experience of my emotions and bodily sensations. I felt the waves of emotions run through my body, and let them flow for a total of up to 90 seconds. And, in so welcoming that experience and allowing it to happen rather than blocking it, fighting it, projecting it (onto my friend or others), I was able to release it and let it go.
For many of us, avoidance is our number one strategy when it comes to our emotions. We don’t like to feel uncomfortable. We don’t like unpleasant sensations, thoughts and feelings and, most of all, we don’t like feeling out of control. Emotions can be painful. In order to avoid these unpleasant experiences, we distract ourselves. We try to numb our bodies and minds to prevent these waves of emotion and bodily sensation from welling up inside of us. We cut ourselves off.
The problem, however is that we can’t just cut off one half of our emotional experience. When we cut off from the negative emotions, we dampen the positive ones as well.
This can result in something that Dr. Rosenberg titles, “soulful depression”, the result of being disconnected from your own personal experience, which includes your thoughts, emotions and body sensations.
Soulful depression is characterized by an internal numbness, or a feeling of emptiness. Over time it can transform into isolation, alienation and hopelessness–perhaps true depression.
Anxiety in many ways is a result of cutting ourselves off from emotional experience as well. It is a coping mechanism: a way that we distract ourselves from the unpleasant emotions we try to disconnect from.
When we worry or feel anxious our experience is often very mental. We might articulate that we are worried about a specific outcome. However, it’s not so much the outcome we are worried about but a fear and desire to avoid the unpleasant emotions that might result from the undesired outcome–the thing we are worrying about. In a sense, anxiety is a way that we distract from the experience of our emotions, and transmute them into more superficial thoughts or worries.
When you are feeling anxious, what are you really feeling?
Dr. Rosenberg writes that there are eight unpleasant feelings:
sadness
shame
helplessness
anger
embarrassment
disappointment
frustration
vulnerability
Often when we are feeling anxious we are actually feeling vulnerable, which is an awareness that we can get hurt (and often requires a willingness to put ourselves out there, despite this very real possibility).
When we are able to stay open to, identify and allow these emotions to come through us, Dr. Rosenberg assures us that we will be able to develop confidence, resilience, and a feeling of emotional strength. We will be more likely to speak to our truth, combat procrastination, and bypass negative self-talk.
She writes, “Your sense of feeling capable in the world is directly tied to your ability to experience and move through the eight difficult feelings”.
Like surfing a big wave, when we ride the waves of the eight difficult emotions we realize that we can handle anything, as the rivers of life are more able to flow through us and we feel more present to our experience: both negative and positive.
One of the important skills involved in “riding the waves” of difficult feelings is to learn to tolerate the body sensations that they produce. For many people, these sensations will feel very intense–especially if you haven’t practice turning towards them, but the important thing to remember is that they will eventually subside, in the majority of cases in under 90 seconds.
Therefore, the key is to stay open to the flow of the energy from these emotions and body sensations, breathe through them and watch them crescendo and dissipate.
This idea reminds me of the poem by Rumi, The Guest House:
This being human is a guest house. Every morning a new arrival.
A joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor.
Welcome and entertain them all! Even if they’re a crowd of sorrows, who violently sweep your house empty of its furniture, still, treat each guest honorably. He may be clearing you out for some new delight.
The dark thought, the shame, the malice, meet them at the door laughing, and invite them in.
Be grateful for whoever comes, because each has been sent as a guide from beyond.
One of the reasons I was so drawn to Dr. Rosenberg’s book is this idea of the emotional waves lasting no more than 90 seconds. We are so daunted by these waves because they require our surrender. It is very difficult however, if you suffer from anxiety to let go of control. To gives these emotional waves a timeframe can help us stick it out. 90 seconds is the length of a short song! We can tolerate almost anything for 90 seconds. I found this knowledge provided me with a sense of freedom.
The 90 seconds thing comes from Dr. Jill Bolt Taylor who wrote the famous book My Stroke of Insight (watch her amazing Ted Talk by the same name). When an emotion is triggered, she states, chemicals from the brain are released into the bloodstream and surge through the body, causing body sensations.
Much like a wave washing through us, the initial sensation is a rush of the chemicals that flood our tissues, followed by a flush as they leave. The rush can occur as blushing, heat, heaviness, tingling, is over within 90 seconds after which the chemicals have completely been flushed out of the bloodstream.
Dr. Rosenberg created a method she calls the “Rosenberg Reset”, which involves three steps:
Stay aware of your moment-to-moment experience. Fully feel your feelings, thoughts, bodily sensations. Choose to be aware of and not avoid your experience.
Experience and move through the eight difficult feelings when they occur. These are: sadness, shame, helplessness, anger, embarrassment, disappointment, frustration, vulnerability.
Ride one or more 90 second waves of bodily sensations that these emotions produce.
Many therapeutic techniques such as mindfulness, Dialectical Behaviour Therapy, somatic therapy, and so on utilize these principles. When we expand our window of tolerance and remain open to our physical and emotional experience we allow energy to move through us more gracefully. We move through our stuckness.
Oftentimes though, we can get stuck underwater, or hung up on the crest of a wave. Rumination and high levels of cortisol, our stress hormone can prolong the waves of unpleasant emotion. We may be more susceptible to this if we have a narrow window of tolerance due to trauma.
However, many of us can get stuck in the mind, and when we ruminate on an emotionally triggering memory over and over again, perhaps in an effort to solve it or to make sense of it, we continue to activate the chemicals in our body that produce the emotional sensation.
Therefore, it’s the mind that can keep us stuck, not the emotions themselves. Harsh self-criticism can also cause feelings to linger.
I have found that stories and memories, grief, terror and rage can become stuck in our bodies. Books like The Body Keeps the Score speak to this–when we block the waves, or when the waves are too big we can build up walls around them. We compartmentalize them, we shut them away and these little 90 second waves start to build up, creating energetic and emotional blockages.
In Vipassana they were referred to as sankharas, heaps of clinging from mental activity and formations that eventually solidify and get lodged in the physical body, but can be transformed and healed.
Perhaps this is why a lot of trauma work involves large emotional purges. Breathwork, plant medicines such as Ayahuasca, and other energetic healing modalities often encourage a type of purging to clear this “sludge” that tends to accumulate in our bodies.
My friend was commenting on the idea that her daughter, about two years old, rarely gets sick. “She’ll have random vomiting spells,” my friend remarked, “and then, when she’s finished, she recovers and plays again”.
“It reminds me of a mini Ayahuasca ceremony”, I remarked, jokingly, “maybe babies are always in some sort of Ayahuasca ceremony.”
This ability to cry, to purge, to excrete from the body is likely key to emotional healing. I was listening to a guest on the Aubrey Marcus podcast, Blu, describe this: when a story gets stuck in a person it often requires love and a permission to move it, so that it may be purged and released.
Fevers, food poisoning, deep fitful spells of sobbing may all be important for clearing up the backlog of old emotional baggage and sludge so that we can free up our bodies to ride these 90 second emotional waves in our moment-to-moment experience.
Grief is one of these primary sources of sludge in my opinion. Perhaps because we live in a culture that doesn’t quite know how to handle grief–that time-stamps it, limits it, compartmentalizes it, commercializes it, and medicates it–many of us suffer from an accumulation of suppressed grief sankharas that has become lodged in our bodies.
Frances Weller puts it this way,
“Depression isn’t depression, it’s oppression–the accumulated weight of decades of untouched losses that have turned into sediment, an oppressive weight on the soul. Processing loss is how the majority of therapies work, by touching sorrow upon sorry that was never honoured or given it’s rightful attention.”
Like a suppressed bowel movement, feelings can be covered up, distracted from. However, when we start to turn our attention to them we might find ourselves running to the nearest restroom. Perhaps in these moments it’s important to get in touch with someone to work with, a shaman of sorts, or a spiritual doula, someone who can help you process these large surges of energy that your body is asking you to purge.
However, it is possible to set our dial to physiological neutral to, with courage turn towards our experience, our emotions and body sensations. And to know that we can surf them, and even if we wipe out from time to time, we might end up coming out the other side, kicking out, as Rumi says, “laughing”.
The only way out is through.
As Jon Kabat Zinn says, “you can’t stop the waves, but you can learn to surf”.
It’s day one of my period and I’ve been healing a broken foot for 6 weeks. The weather is overcast, thick, humid and rainy.
My body feels thick and heavy. Clothing leaves an imprint on my skin–socks leave deep indentations in my ankles. My face and foot is swollen. My tongue feels heavy. My mind feels dull, achey, and foggy. It’s hard to put coherent words together.
I feel cloudy and sleepy. Small frustrations magnify. It’s hard to maintain perspective.
My muscles ache. My joints throb slightly. They feel stiffer and creakier.
This feeling is transient. The first few days of the menstrual cycle are characterized by an increase in prostaglandins that stimulate menstrual flow and so many women experience an aggravation of inflammatory symptoms like depression, arthritis, or autoimmune conditions around this time. You might get. a cold sore outbreak, or a migraine headache around this time of month. The phenomenon can be exaggerated with heavy, humid weather, and chronic inflammation–such as the prolonged healing process of mending a broken bone.
Inflammation.
It’s our body’s beautiful healing response, bringing water, nutrients, and immune cells to an area of injury or attack. The area involved swells, heats up, becomes red, and might radiate pain. And then, within a matter of days, weeks, or months, the pathogen is neutralized, the wound heals and the inflammatory process turns off, like a switch.
However, inflammation can be low-grade and chronic. Many chronic health conditions such as diabetes, arthritis, PMS or PMDD, depression, anxiety, migraines, even bowel and digestive issues, have an inflammatory component.
In the quest to manage chronic inflammation, people often explore various avenues, including dietary supplements. One such natural option gaining attention is OrganicCBDNugs. Derived from the hemp plant, CBD, or cannabidiol, is believed to possess anti-inflammatory properties, potentially offering relief to those struggling with conditions like arthritis, anxiety, or migraines.
This organic supplement, with its purported ability to interact with the body’s endocannabinoid system, might provide a holistic approach to tackling inflammation-related issues. As we navigate the complexities of our bodies and the ebb and flow of inflammation, exploring natural remedies like Organic CBD could be a step toward finding equilibrium and promoting overall well-being.
As I telly my patients. Inflammation is “everything that makes you feel bad”. Therefore anti-inflammatory practices make you feel good.
Many of us don’t realize how good we can feel because low-grade inflammation is our norm.
We just know that things could be better: we could feel more energy, more lightness of being and body, more uplifted, optimistic mood, clearer thinking and cognitive functioning, better focus, less stiffness and less swelling.
Obesity and weight gain are likely inflammatory processes. Insulin resistance and metabolic syndrome are inflammatory in nature. It’s hard to distinguish between chronic swelling and water retention due to underlying low-grade chronic inflammation and actual fat gain, and the two can be closely intertwined.
It’s unfortunate then, that weight loss is often prescribed as a treatment plan for things like hormonal imbalances, or other conditions caused by metabolic imbalance. Not only has the individual probably already made several attempts to lose weight, the unwanted weight gain is most likely a symptom, rather than a cause, of their chronic health complaint. (Learn how to get to the root of this with my course You Weigh Less on the Moon).
Both the main complaint (the migraines, the PMS, the endometriosis, the depression, the arthritis, etc.) and the weight gain, are likely due to an inflammatory process occurring in the body.
To simply try to cut calories, or eat less, or exercise more (which can be helpful for inflammation or aggravate it, depending on the level of stress someone is under), can only exacerbate the process by creating more stress and inflammation and do nothing to relieve the root cause of the issues at hand.
Even anti-inflammatory over the counter medications like Advil, prescription ones like naproxen, or natural supplements like turmeric (curcumin) have limiting effects. They work wonderfully if the inflammation is self-limiting: a day or two of terrible period cramps, or a migraine headache. However, they do little to resolve chronic low-grade inflammation. If anything they only succeed at temporarily suppressing it only to have it come back with a vengeance.
The issue then, is to uncover the root of the inflammation, and if the specific root can’t be found (like the piece of glass in your foot causing foot pain), then applying a general anti-inflammatory lifestyle is key.
The first place to start is with the gut and nutrition.
Nutrition is at once a complex, confusing, contradictory science and a very simple endeavour. Nutrition was the simplest thing for hundreds of thousands of years: we simply ate what tasted good. We ate meat, fish and all the parts of animals. We ate ripe fruit and vegetables and other plant matter that could be broken down with minimal processing.
That’s it.
We didn’t eat red dye #3, and artificial sweeteners, and heavily modified grains sprayed with glyphosate, and heavily processed flours, and seed oils that require several steps of solvent extraction. We didn’t eat modified corn products, or high fructose corn syrup, or carbonated drinks that are artificially coloured and taste like chemicals.
We knew our food—we knew it intimately because it was grown, raised, or hunted by us or someone we knew—and we knew where it came from.
Now we have no clue. And this onslaught of random food stuffs can wreck havoc on our systems over time. Our bodies are resilient and you probably know someone who apparently thrives on a diet full of random edible food-like products, who’s never touched a vegetable and eats waffles for lunch.
However, our capacity to heal and live without optimal nutrition, regular meals that nourish us and heal us rather than impose another adversity to overcome, can diminish when we start adding in environmental chemicals and toxins, mental and emotional stress, a lack of sleep, and invasion of blue light at all hours of the day, bodies that are prevented from experiencing their full range of motion, and so on.
And so to reduce inflammation, we have to start living more naturally. We need to reduce the inflammation in our environments. We need to put ourselves against a natural backdrop–go for a soothing walk in nature at least once a week.
We need to eat natural foods. Eat meats, natural sustainably raised and regeneratively farmed animal products, fruits and vegetables. Cook your own grains and legumes (i.e.: process your food yourself). Avoid random ingredients (take a look at your oat and almond milk–what’s in the ingredients list? Can you pronounce all the ingredients in those foods? Can you guess what plant or animal each of those ingredients came from? Have you ever seen a carageenan tree?).
Moving to a more natural diet can be hard. Sometimes results are felt immediately. Sometimes our partners notice a change in us before we notice in ourselves (“Hon, every time you have gluten and sugar, don’t you notice you’re snappier the next day, or are more likely to have a meltdown?”).
It often takes making a plan–grocery shopping, making a list of foods you’re going to eat and maybe foods you’re not going to eat, coming up with some recipes, developing a few systems for rushed nights and take-out and snacks–and patience.
Often we don’t feel better right away–it takes inflammation a while to resolve and it takes the gut time to heal. I notice that a lot of my patients are addicted to certain chemicals or ingredients in processed foods and, particularly if they’re suffering from the pain of gut inflammation, it can tempting to go back to the chemicals before that helped numb the pain and delivered the dopamine hit of pleasure that comes from dealing with an addiction. It might help to remember your why. Stick it on the fridge beside your smoothie recipe.
We need to sleep, and experience darkness. If you can’t get your bedroom 100%-can’t see you hand in front of your face-dark, then use an eye mask when sleeping. Give your body enough time for sleep. Less than 7 hours isn’t enough.
We need to move in all sorts of ways. Dance. Walk. Swim. Move in 3D. Do yoga to experience the full range of motion of your joints. Practice a sport that requires your body and mind, that challenges your skills and coordination. Learn balance both in your body and in your mind.
We need to manage our emotional life. Feeling our emotions, paying attention to the body sensations that arise in our bodies—what does hunger feel like? What does the need for a bowel movement feel like? How does thirst arise in your body? Can you recognize those feelings? What about your emotions? What sensations does anger produce? Can you feel anxiety building? What do you do with these emotions once they arise? Are you afraid of them? Do you try to push them back down? Do you let them arise and “meet them at the door laughing” as Rumi says in his poem The Guest House?
Journalling, meditation, mindfulness, hypnosis, breath-work, art, therapy, etc. can all be helpful tools for understanding the emotional life and understanding the role chronic stress (and how it arises, builds, and falls in the body) and toxic thoughts play in perpetuating inflammation.
Detox. No, I don’t mean go on some weird cleanse or drinks teas that keep you on the toilet all day. What I mean is: remove the gunk and clutter from your physical, mental, spiritual, and emotional plumbing. This might look like taking a tech break. Or going off into the woods for a weekend. Eating animals and plants for a couple of months, cutting out alcohol, or coffee or processed foods for a time.
It might involve cleaning your house with vinegar and detergents that are mostly natural ingredients, dumping the fragrances from your cosmetics and cleaning products, storing food in steel and glass, rather than plastic. It might mean a beach clean-up. Or a purging of your closet–sometimes cleaning up the chaos in our living environments is the needed thing for reducing inflammation. It’s likely why Marie Kondo-ing and the Minimalist Movement gained so much popularity–our stuff can add extra gunk to our mental, emotional, and spiritual lives.
Detoxing isn’t just a trendy buzzword; it’s about fostering clarity and wellness in every aspect of our lives, including our living spaces. A clean, organized home can significantly contribute to a healthier mindset and emotional balance. That’s where Clean 4 You comes in, offering a fresh perspective on home cleaning that goes beyond mere tidiness.
They understand that clutter and grime can weigh heavily on our mental and emotional states, which is why they provide services tailored to create an environment that supports your detox journey. By enlisting the help of professionals, you can focus on nurturing yourself while they take care of transforming your space into a sanctuary.
If you’re seeking assistance specifically designed for individuals with unique needs, the NDIS Cleaner Perth service from Clean 4 You is here to help. This dedicated team is trained to cater to the requirements of those on the National Disability Insurance Scheme, ensuring that every client receives the support they need for a clean and safe living environment.
With a commitment to using eco-friendly products and methods, Clean 4 You allows you to detox your home in a way that aligns with your values, providing peace of mind as you embrace a healthier lifestyle. With their expertise, you can achieve a pristine space that not only looks good but feels good, allowing you to focus on your personal wellness journey.
Finally, connect with your community. Loneliness is inflammatory. And this past year and a half have been very difficult, particularly for those of you who live alone, who are in transition, who aren’t in the place you’d like to be, or with the person or people you’d like to be–your soul family.
It takes work to find a soul family. I think the first steps are to connect and attune to oneself, to truly understand who you are and move toward that and in that way people can slowly trickle in.
We often need to take care of ourselves first, thereby establishing the boundaries and self-awareness needed to call in the people who will respect and inspire us the most. It’s about self-worth. How do you treat yourself as someone worthy of love and belonging?
Perhaps it first comes with removing the sources of inflammation from our lives, so we can address the deeper layers of our feelings and body sensations and relieve the foggy heaviness and depression and toxic thoughts that might keep us feeling stuck.
Once we clear up our minds and bodies, and cool the fires of inflammation, we start to see better—the fog lifts. We start to think more clearly. We know who we are. Our cravings subside. We can begin to process our shame, anger and sadness.
We start to crave nourishing things: the walk in nature, the quiet afternoon writing poetry, the phone call with a friend, the stewed apples with cinnamon (real sweetness). We free up our dopamine receptors for wholesome endeavours. We start to move in the direction of our own authenticity. I think this process naturally attracts people to us. And naturally attracts us to the people who have the capacity to love and accept us the way we deserve.
Once we start to build community, especially an anti-inflammatory community—you know, a non-toxic, nourishing, wholesome group of people who make your soul sing, the path becomes easier.
You see, when you are surrounded by people who live life the way you do–with a respect for nature, of which our bodies are apart–who prioritize sleep, natural nutrition, mental health, movement, emotional expression, and self-exploration, it becomes more natural to do these things. It no longer becomes a program or a plan, or a process you’re in. It becomes a way of life–why would anyone do it any other way?
The best way to overcome the toxicity of a sick society is to create a parallel one.
When you’re surrounded by people who share your values. You no longer need to spend as much energy fighting cravings, going against the grain, or succumbing to self-sabotage, feeling isolated if your stray from the herb and eat vegetables and go to sleep early.
You are part of a culture now. A culture in which caring for yourself and living according to your nature is, well… normal and natural.
There’s nothing to push against or detox from. You can simply rest in healing, because healing is the most natural thing there is.
Whenever I sit with a new patient for an initial intake, I ask about cravings.
From my many conversations about food, appetite and cravings, the most common responses are cravings for salt, or sugar, with many people falling on one end of the preference than the other: “I’m a salt craver” or “I’ve got a sweet tooth”.
However, cravings are so much more than that.
I believe that they are a beautifully intricate process, in which our body is trying to speak to us about what it needs.
Our bodies have developed taste receptors to detect quality nutrients from the environment. While these days sugar is abundant wherever you turn, during our hunter-gatherer times, it was a relatively scarce and highly sought after taste–the taste of ripe fruit, rich with nutrients, the taste of quality calories from carbohydrates, which may have been scarce in times of food shortage or famine.
Salt or “savoury” or umami cravings, often represent a need for more protein. Unfortunately, many of my patients who crave salt (and often calories) find themselves the bottom of a bag of chips, rather than grilling up a chicken breast.
Our modern environment doesn’t necessarily set us up to adequately translate and respond properly to certain cravings. Salted chips were probably not a thing in a natural environment and the only way to satisfy a salt and savoury craving would have been through hunting, consuming meat, or eggs and poultry.
When I was travelling in Colombia I was obsessed with broccoli–it was like I couldn’t get enough of it.
The same thing happened on a month-long trip to Brazil in 2019. Broccoli is rich in vitamin C, sulphur, and certain amino acids. It’s also a decent source of calcium. I’m not sure what nutrient I may have been lacking on my travels, but it’s possible that those cravings meant something for my body. And so I honoured them–I sought out broccoli like it was a magic elixir of health and ate as much of it as I could.
After developing significant iron deficiency after spending a few years as a vegetarian, I became suddenly attracted by the smell of roasting chicken from a local Korean restaurant I was passing by while walking the streets of Toronto.
The wafting smell of roasting poultry was majestic and impossible to ignore. It didn’t smell like sin, or temptation–my body betraying my moral sensibilities or whatever else we often accuse our cravings of—it smelt… like health.
There was no doubt in my mind as the delicious fumes touched my nostrils that I needed to honour my body and start eating meat again. I did and my health and nutrient status has never been better.
Patients will report craving carbs and chocolate the week before their period. The eb and flow of estrogen can affect serotonin levels. A large dose of carbs allows tryptophan, the amino acid that forms the backbone of serotonin, to freely enter the brain. This explains the effect “comfort foods” like starchy warm bread and pasta have on us, creating that warm, after-Thanksgiving dinner glow.
Chocolate is rich in magnesium, a nutrient in which many of us are deficient, that is in higher demand throughout the luteal phase of our cycle, or our premenstrual week.
Cravings are not just nagging, annoying vices, thrust in the path to greater health and iron discipline. They’re complex, intuitive and beautiful. They may be important landmarks on the path to true health and wellness.
Disciplines like Intuitive Eating and Mindful Eating have based themselves on the idea that our bodies hold intuitive wisdom and our tastes, cravings and appetites may be essential for guiding us on a road to health. Through removing restriction and paying more attention to the experience of food, we may be better guided to choose what foods are right for us.
The book The Dorito Effect outlines how our taste cues have been hijacked by Big Food. Like having a sham translator, processed foods stand between essential nutrients and the signals our bodies use to guide us to them. A craving for sweet that might have led you to ripe fruit, now leads you to a bag of nutrient-devoid candy that actually robs you of magnesium, and other nutrients in order to process the chemicals. A craving for salt and umami, or hunger for calories leads you to polish off a bag of chips, which are protein-devoid and laden with inflammatory fats, and only trigger more cravings, and shame.
It’s no wonder that we don’t trust our cravings– we live in a world that exploits them at every turn.
Clara Davis in 1939 was curious about the instintual nature of human cravings and devised a study that was published in the Canadian Medical Assoication Journal (CMAJ). The study was called Self-Selection of Diets by Young Children.
Clara gathered together 15 orphaned infants between 6 to 11 months of age who were weaning from breast-feeding and ready to receive solid food for the first time. These infants, before the study had never tried solid food or supplements. They were studied ongoing for a period of 6 years, with the main study process was conducted over a period of months.
The babies were sat at a table with a selection of simple, whole foods–33 to be exact. The foods contained no added sugars or salt. They were minimally cooked. Not all 33 were presented to each baby at each meal, however the babies were offered an opportunity to try everything.
The foods they were offered were water, sweet milk, sour (lactic) milk, sea salt, apples, bananas, orange juice, pineapple, peaches, tomatoes, beets, carrots, peas, turnips, cauliflower, cabbage, spinach, potato, lettuce, oatmeal, wheat, corn meal, barley, Ry-krisp (a kind of cereal), beef, lamb, bone marrow, bone jelly, chicken, sweetbreads, brains, liver, kidneys, eggs, and fish (haddock).
The nurses who were involved in running the study were instructed to sit in front of the infants with a spoon and wait for them to point at foods that they wanted. The nurses were not to comment on the choices or foods in any way, but wordlessly comply with the infants’ wishes and offer them a spoonful of the chosen foodstuff.
Throughout the study Davis noted that all the infants had hearty appetites and enjoyed eating.
At first, the babies showed no instinct for food choices, selecting things at random, and exploring the various foods presented to them. All of them tried everything at least once (two babies never tried lettuce and one never explored spinach). The most variety of food choices occurred during the first two weeks of the study when they were presumably in their experimentation phase.
Their tastes also changed from time to time, perhaps reflecting some hidden, internal mechanism, growth spurt or nutritional need. Sometimes a child would have orange juice and liver for breakfast (liver is a source of iron, and vitamin C from the orange juice aids in its absorption), and dinner could be something like eggs, bananas, and milk.
Many infants began the study in a state of malnourishment. Four were underweight and five suffered from Rickets a condition caused by extremely low vitamin D. One of the babies with severe Rickets was offered cod liver oil in addition to the other food options. Cod liver oil is a rich source of vitamin D.
The infant selected cod liver oil often for a while, after which his vitamin D, phosphorus and calcium blood levels all returned to normal range, and x-rays showed that his Ricket’s healed.
It is often thought by parents that children, if left to their own devices will eat themselves nutrient-deficient. While that may be true in todays’ landscape of processed frankenfoods, the infants in Davis’ study consumed a diet that was balanced and high in variety. They got 17% of their calories from protein, 35% from fat and 48% from carbohydrates and intake depended on their activity levels.
During the 6 years in which the infants’ eating habits were under observation, they rarely suffered from health issues. They had no digestive issues, like constipation. If they came down with a cold it would last no more than 3 days before they were fully recovered.
In the 6 years, they became ill with a fever only once, an outbreak that affected all of the infants in the orphanage. The researchers noticed their appetites change in response to the illness.
During the initial stages of the fever, they had lower appetites. And, once the fevers began to resolve, their appetites came back with a vengeance. They ate voraciously, and it was interesting that most of them showed an increased preference for raw carrots, beef and beets–which may indicate a need for vitamin A, iron and protein, which are needed for immune system function and recovery.
The habits of the infants to crave and select medicinal foods during times of fever and nutrient deficiency is such compelling evidence of Clara Davis’ craving wisdom hypothesis—were their bodies telling them what they needed to heal?
The self-selected, whole foods diets seems to have a positive impact on the mood and behaviours of the babies, all of whom were living full-time at the orphanage.
A psychiatrist, Dr. Joseph Brennemann wrote an article on them entitled “Psychologic Aspects of Nutrition” in the Journal of Pediatrics on their mood, behaviour and affect, “I saw them on a number of occasions and they were the finest group of specimens from the physical and behaviour standpoint that I have even seen in children of that age.”
In our world we often try to mentalize our food choices: going vegan or low-fat, counting calories, or reducing carbs. We time our eating windows, fast, or try to exert discipline and will over our bodies’ inherent desires.
So often my patients need to be coached through food eliminations, or given meal plans and templates. The art of listening to the body: properly identifying hunger, thirst, fatigue, inflammation, and even emotions like boredom, anxiety, sadness, anger, and hurt, can be a long process.
And yet, I wonder if we clear our palates and offer them a variety of whole, unprocessed, fresh foods, if our bodies will settle into their own grooves–perhaps our health will optimize, our bodies will be able to more readily communicate what they need, our taste receptors and cravings will adjust, and our cravings and appetite will serve the purpose they were meant to–to tell us what we need more of and what need less of or not at all.
I wonder if we listen, what our bodies will tell us.
I wonder if we let them, if our bodies will exhibit the pure instinctual wisdom of nature and the quest for harmony and homeostasis that lies at the heart of our natural world.
About a month ago I fractured my right 5th metatarsal (an avulsion fracture, aka “The Dancer’s Fracture” or a “Pseudo-Jones Fracture”).
As soon as I laid eyes on the x-ray and the ER doctor declared, “Ms. Marcheggiani,” (actually, it’s doctor, but ok) “you broke your foot!” things changed.
I have never broken anything before, but if you have you know what it’s like. In a matter of seconds I couldn’t drive. I could barely put weight on it. I was given an Aircast boot to hobble around in, and told to ice and use anti-inflammatories sparingly. My activities: surfing, skateboarding, yoga, even my daily walks, came to a startling halt.
I spent the first few days on the couch, my foot alternating between being elevated in the boot and immersed in an ice bath. I took a tincture with herbs like Solomon’s Seal, mullein, comfrey, and boneset to help heal the bone faster. I was adding about 6 tbs of collagen to oats in the morning. I was taking a bone supplement with microcrystalline hydroxyapatite, pellets of homeopathic symphytum, zinc, and vitamin D.
We call this “treatment stacking”: throwing everything but the kitchen sink at something to give the body as many resources as possible that it may use to heal.
My brother’s wedding came and went. I was the emcee, and the best man. I bedazzled my boot and hobbled around during set-up, photos, presentations, and even tried shaking and shimmying, one-legged on the dance floor. The next few days I sat on the couch with my leg up.
I watched the Olympics and skateboarding videos. I read The Master and the Margarita and Infinite Jest. I got back into painting and created some pen drawings, trying to keep my mind busy.
I slept long hours–an amount that I would have previously assumed to be incapable. The sleep felt necessary and healing. I was taking melatonin to deepen it further.
I closed down social media apps on my phone to deal with the immense FOMO and stop mindlessly scrolling. I journaled instead, turning my focus from the outside world to my inner one.
It was a painful process, and not necessarily physically.
I was confined to my immediate surroundings–not able to walk far or drive. I was at the mercy of friends and family to help me grocery shop. The last year and a half has made many of us grow accustomed to social isolation and a lot of my social routines from years prior had fallen by the wayside.
My world, like the worlds of many, had gotten smaller over the last 18 months. With a broken foot, my world shrunk even further.
The loneliness was excruciating.
It would come in waves.
One moment I would relish the time spent idle and unproductive. The next I would be left stranded by my dopamine receptors, aimless, sobbing, grieving something… anything… from my previous life. And perhaps not just the life I had enjoyed pre-broken foot, but maybe a life before society had “broken”, or even before my heart had.
I thought I would be more mentally productive and buckle down on work projects but it became painfully obvious that my mental health and general productivity are tightly linked to my activity levels. And so I spent a lot of the weeks letting my bone heal in a state of waiting energy.
My best friend left me a voicemail that said, “Yes… you’re in that waiting energy. But, you know, something will come out of it. Don’t be hard on yourself. Try to enjoy things… watch George Carlin…”
During the moments where I feel completely useless and unproductive, waiting for life to begin, I was reminded of this quote by Cheryl Strayed. This quote speaks to me through the blurry, grey haze of boredom and the existential urgency of wasting time.
It says,
“The useless days will add up to something. The shitty waitressing jobs. The hours writing in your journal. The long meandering walks. The hours reading poetry and story collections and novels and dead people’s diaries and wondering about sex and God and whether you should shave under your arms or not. These things are your becoming.”
These things are your becoming.
Something will come out of it.
When I did a 10-Day Vipassana (silent meditation) retreat in the summer of 2018, I learned about pain.
It was Day 3 or 4 and we had been instructed to sit for an entire hour without moving. The pain was excruciating. The resistance was intense. I was at war with myself and then, when the gong went off and there was nothing to push against, I noticed a complete relief of tension. I was fine.
The next time I sat to meditate (another hour after a 10 minute break), I observed the resistance and released it. It’s hard to describe exactly what I did. It was something like, letting the sensations of pain flow through me like leaves on a river, rather than trying to cup my hands around them, or understand or making meaning out of them.
The sensations ebbed and flowed. Some might have been called “unpleasant” but I wasn’t in a space to judge them while I was just a casual observer, watching them flow by. They just were.
And when I have intense feelings of loneliness, boredom or heart-break I try to remember the experience I had with pain and discomfort on my meditation cushion. I try to allow them.
“This too shall pass”.
When I have a craving to jump off my couch and surf, or an intense restlessness in the rest of my body, the parts that aren’t broken, I try to let those sensations move through me.
I notice how my foot feels. How while apparently still, beneath my external flesh my body is busy: it’s in a process. It’s becoming something different than it was before. It’s becoming more than a foot that is unbroken. It’s becoming callused and perhaps stronger.
Maybe my spirit is in such a process as well.
The antidote to boredom and loneliness very often is a process of letting them move through, of observing the sensations and stepped back, out of the river to watch them flow by. A patience. Letting go.
I can’t surf today. But, it is the nature of waves that there will always be more.
Pima Chodron in her book When Things Fall Apart also references physical pain and restless in meditation while speaking of loneliness.
She writes,
“Usually we regard loneliness as the enemy. Heartache is not something we choose to invite in. It’s restless and pregnant and hot with desire to escape and find something or someone to keep us company. When we can rest in the middle, we begin to have a nonthreatening relationship with loneliness, a relaxing and cooling loneliness that completely turns our usual fearful patterns upside down.”
She continues,
“When you wake up in the morning and out of nowhere comes the heartache of alienation and loneliness, could you use that as a golden opportunity? Rather than persecuting yourself or feeling that something terribly wrong is happening, right there in the moment of sadness and longing, could you relax and touch the limitless space of the human heart?
“The next time you get a chance, experiment with this.”
Is anyone else feeling wet dog in a bathtub-level lonely? With this pandemic loneliness is on the rise. And we already lived in an epidemic of loneliness. Humans are social creatures with attachment needs–and many of us are alone or surrounded by people who make us feel more alone. Sometimes loneliness doesn’t make sense.
This is a time when loneliness has turned from epidemic to global pandemic.
As we physically distance, the emotional distance between each other becomes greater.
I don’t have a solution to loneliness, but the great minds of neuroscience, psychology, literature, philosophy, and spirituality have written on it a great deal, and so I’m going to examine some of it in the following paragraphs.
1. “Saying Hello Again” When I first announced this project, many people reached out to me and talked about their grief: the loss of a spouse, a beloved pet.
Many more of us are grieving relationships with those who haven’t died, but who we don’t get to interact with as much anymore. Grief is a tricky subject. In our society we don’t have established rituals for grieving. In the DSM if you’ve lost a loved one more than two weeks ago, and your grief coincides with the symptoms for Major Depressive Disorder, you’re considered mentally ill.
Imagine losing someone important to you and not feeling depressed for more than two weeks…
In many instances we NEVER “get over” the pain of losing someone. And yet, in many ways, grief that interferes with our productivity and way of being is pathologized. Narrative Therapy invites us to grieve in ways that I have always felt were the richest and most helpful. It does this through a series of “Remembering Conversations”. (For more, I’ve linked to the paper “Saying Hello Again” by David Denborough.) You can speak remembering conversations out loud with a friend or therapist. You can write them down, or walk in the woods and reminisce. Find a quiet space where you can think of your loved one. It could be someone real, currently alive but not present–a religious figure, or a famous person. A stuffed animal. A pet. An ex-lover. Or someone who has passed away. Call them into your memory, and consider the questions. – What did [your loved one] see when they looked at you through loving eyes? – How did they know these things about you? – If they could be with you today, what would they say to you about the efforts you are making in your life? What words of encouragement would they offer? – What difference would it make to your relationships with others if you carried this knowledge with you in your daily life?
2. Feeling Lonely vs. Being Alone. “You come home, make some tea, sit down in your armchair, and all around there’s silence. Everyone decides for themselves whether that’s loneliness or freedom.” Surely solitude and loneliness are related but not equivalents. My patients and friends who are married with children crave alone time. My single friends who live alone crave company. What most of us want, however, is the feeling of freedom that comes with being ourselves. And we all know that this feeling can arise alone in the comfort of our own company or in the presence of those who fully accept us. The Dalai Lama has repeatedly claimed that he never gets lonely.
When he was asked the question “Do you get lonely?” at a speaking forum, it took the translator a while to convey the concept to him before he was able to answer. According to him, loneliness is not a condition of solitude. It’s a condition of mindset.
He weighs in: “We often are alone without feeling lonely and feel lonely when we are not alone, as when we are in a crowd of strangers or at a party of people we do not know. “Clearly the psychological experience of loneliness is quite different from the physical experience of being alone. “We can feel joy when we are alone but not when we are lonely… Much depends on your attitude. If you are filled with negative judgement and anger, then you will feel separate from other people. You will feel lonely. “But if you have an open heart and are filled with trust and friendship, even if you are physically alone, even living a hermit’s life, you will never feel lonely.” The loneliest I’ve felt is when I was in a relationship with someone whose love I couldn’t feel. But, I’ve felt completely at home and accompanied while traveling with strangers. When do you feel you can truly be as you are?
3. On being socially awkward and telling ourselves stories. We were in the midst of … isolation and so my friends cancelled their baby shower. They asked for books (if we were compelled to send gifts) and something else, I don’t remember…(clothes?) So I hopped on Amazon and happily ordered a few books I remember loving as a kid: Amos the sheep who doesn’t want to give up his wool, Frances the badger who gets conned into giving up her porcelain tea set in lieu of a plastic one, and so on. My friend is a therapist and I was sure he’d appreciate the psychotherapeutic subtext of these stories: finding self-worth, developing boundaries, etc. Anyways, I sent the books off and forgot about it. Then, one lonely evening I sat on the couch alone and let my Default Mode Network run rampant. I started ruminating on the books–they must have arrived. I hadn’t heard from my friends. Maybe they were going to send out more formal thank you card.
Or maybe something was wrong. Then I realized that they were about to have a BABY, a mere fetus+1 day. And I realized in horror I had sent them a pile of children’s books–for 3-5 year olds.
I felt out of touch, self-absorbed–I felt ashamed. And then I felt ashamed at my shame–surely this wasn’t such a big deal? What was wrong with me? I tried to Cognitive Behaviour Therapy my way out of this thought trap–this story about being weird and disconnected. I couldn’t do it. I eventually reached out to another friend who has two kids. She played the role of my prefrontal cortex (using others for emotional regulation is extremely helpful). She assured me that babies can’t read anyways and so, whatever, any kind of book is fine. Duh… then I realized: this is the collateral of isolation.
If the gifts had been unwrapped in person, I might have realized they were slightly age inappropriate and would have made a joke. People would have laughed, we would have moved on. Instead, my mind was free to fill the silent void with stories. Eventually I confessed my neuroticism to my friends, embarrassed. They laughed and thanked me for the gift. We tell ourselves stories about how others see us all the time. About their judgements and prejudices, motivations, anger, hostility and failings.
What story are you telling yourself about the people in your life?
4. The Power of Art. Remember this scene from the movie Good Will Hunting? Sean : [during a therapy session, after coming from the job interview with the NSA] Do you feel like you’re alone, Will? Will : [laughs] What? Sean : Do you have a soul mate? Will : Define that. Sean : Somebody who challenges you. Will : I have Chuckie. Sean : You know Chuck; he’s family. He’d lie down in fuckin’ traffic for you. No, I’m talking about someone who opens up things for you – touches your soul. Will : I got – I got… Sean : Who? Will : …I got plenty. Sean : Well, name them. Will : Shakespeare, Nietzsche, Frost, O’Connor, Pope, Locke… Sean : That’s great. They’re all dead. Will : Not to me they’re not.
This exchange has always come to mind when I think about the loneliness of trying to find a soulmate–someone who knows the secrets and truths that lie deep in our hearts. Do our soulmates need to be living people who we share our lives with? People we can converse with on a daily basis? Ideally yes. However, many people in literature will speak of the phenomenon about feeling alone in a crowded room, with no one to share their private thoughts. When we read someone’s deep thoughts and feelings and relate it… makes us feel less alone, especially if what we’re reading speaks directly to our own hearts. You know that sensation, when you’re feeling something really deeply and then you read or hear someone else (maybe someone you know, maybe someone famous, or dead) describe that phenomenon in a way that is far more eloquent and articulate than you feel you ever could?
That feeling of being deeply validated and understood. Literary soulmates. People who have thought long and hard about this particular existential human experience you’re going through right now.
Not only have they lived it, but they’ve taken the trouble to put it into words, images, music. To remind you that you’re sharing a nervous system with 8 billion other living human beings . To remind you that you’re not alone.
5. Making Friends as an Adult aka Going After What Lights You Up. “You can’t make friends in your 30s”.
My friend’s brother is an investment banker in Manhattan and this was his claim a few years ago. My friend, a bonafide hippie (they are hilarious opposites) and I wondered if it was true. I’ve spent pockets of my adult life wishing I had more friends. I’ve had long conversations with patients who wish they had more friends, or are looking to date and having trouble meeting people. One of the things I was grieving during the last few months was loss of the spontaneity of meeting people.
No more picnics on the Island where a random group of people invite me to share their wine and then write letters to my Nonna.
No more “networking” events I decide at the last minute to drop in on, where I meet a friend who introduces me to someone who would soon be a best friend. No more of that randomness. A contraction of possibilities. The same friend wrote to me, in an email we sent to each other in our early 20s when we were out of school and trying to find our way. “I don’t even know what it is about making friends. It can just be so random the way you meet someone in passing you might really connect [with] or you might ignore each other after 5 minutes and never speak again.
“The philosophy is right — if you go after what lights you up you are bound to stumble upon someone else who is lit on that in their own way and for their own reasons so you are bound to connect on some level!” And, of course we’ve heard this so many times: go after what you’re passionate about and the people will trickle in, like a kind of osmotic current. And it’s easier said that done, finding out what lights you up. I suppose it starts with creating an open question and waiting for the answer to show itself. Lake surfing was one of the answers that manifested itself to me. It’s been a blessing for me in so many ways–from even finding out it existed, to randomly meeting people in the line-up to my regular surf buddies, to the photographers who celebrate us on social media, the sport, although technically a solo one, is all about connectivity. Water is sticky. so are we.
6. Self-Soothing. Will scientists and drug companies create a pill for loneliness? Hormones like oxytocin, endogenous opioids (our body’s own morphine) and allo-pregnenalone, a steroid hormone related to estrogen, progesterone, testosterone, and cortisol, are all common targets for “medicating” loneliness. We can medicate loneliness ourselves, however through self-soothing. Self-soothing behaviours include: – talking about your emotions with others – social and physical warmth (getting cozy and Hygge) – Touching, including self touch and self holds – Soothing music – Satiety through consuming high-calorie foods (chocolate, anyone?) – And even drugs, although engaging in the above self-soothing behaviours tends to protect against drug addiction in the research–if you’re able to reach for a cozy sweater and a puppy in order to self-soothe you’re probably less likely to turn to alcohol. Self-soothing behaviours increase oxytocin in the brain. They calm areas of the brain like the insula and amygdala that are associated with anxiety. Self-soothing boosts endogenous opioids (research shows that opioids like morphine help calm the sting of social rejection, which our brain perceives to be the same as physical pain), and serotonin and dopamine. Self-touch or self-holds is an excellent way to self-soothe. In my podcast on Polyvagal Theory with Dr. Steph Cordes, we talk about self-touch: things like putting a hand on your chest, wrapping your arms around yourself, child’s pose, or cupping your face in your hand. Sometimes speaking your own emotions can be helpful (“I feel sad right now” or “This is hard”). Also, particularly where these emotions pertain to loneliness, invoking a common humanity can he a helpful tool for feeling less alone and can help soothe and process hard feelings. “Everyone feels this way sometimes”, or “Suffering is a part of life”. In Mindful Self-Compassion, invoking a common humanity is an important step in taking the burden of our feelings off of ourselves and recognizing that we’re all interconnected in the emotional space. How do you self-soothe?
7. Attunement. “[Attuning with others] is at the heart of the important sense of “feeling felt” that emerges in close relationships. “Children need attunement to feel secure and to develop well, and throughout our lives we need attunement to feel close and connected.” – Dan Siegel, MD Attunement is the process of responding to another’s emotional cues. Infants first learn attunement from their parents. When a parent can read a baby’s expressions or hear her cries and respond appropriately: with comfort, food, warmth, a diaper change, it builds a sense of trust in the infant’s body. The baby feels seen and understood by the world. A lack of attunement can cause attachment insecurity: leading to feelings of anxiety, distrust, emotional avoidance, depression, and relationship dissatisfaction. It’s ultimately lack of attunement that results in mental health challenges in an adult’s life. Attuning to others can be hard if you didn’t receive the proper attunement from your parents. However, we can still learn to attune to ourselves and others as adults.
Here are some tips for learning how to be more attuned: – Attune to yourself first: starting by recognizing what you feel in your body: what thoughts, emotions and feelings are present? How are you breathing? – Practicing mindfulness can help you understand what is going on in your body and mind, as you learn to attune to yourself emotionally. – When trying to attune to another, limit distractions (turning off the TV, putting away cellphones, etc.) so that you can fully pay attention to the emotional space. – Make eye contact and mirror the others’ physical cues: mimic their postures, gestures and even tone of voice. Physical mirroring is a hallmark skill of attunement. – Listen carefully with compassionate curiosity: seek to understand before seeking to be understood (a useful cliche). Can you give the other person the benefit of the doubt? Can you try your best to relate to what they might be staying and hold them in what Carl Rogers called “Unconditional Positive Regard”? – Can you try to identify what emotions someone might be experiencing as you talk to or sit with them? What are you feeling in your own body?
8. Sharing the Things that Matter “Loneliness isn’t the physical absence of other people – it’s the sense that you’re not sharing anything that matters with anyone else.”
— Johann Hari, from his book Lost Connections. Johann also writes: “Be you. Be yourself… “We say it to encourage people when they are lost, or down. Even our shampoo bottles tell us—because you’re worth it. But what I was being taught is—if you want to stop being depressed, don’t be you. Don’t be yourself. Don’t fixate on how you’re worth it. It’s thinking about you, you, you that’s helped to make you feel so lousy. Don’t be you. “Be us. Be we. Be part of the group. Make the group worth it. “The real path to happiness, they were telling me, comes from dismantling our ego walls—from letting yourself flow into other people’s stories and letting their stories flow into yours; from pooling your identity, from realizing that you were never you—alone, heroic, sad—all along. “No, don’t be you. Be connected with everyone around you. Be part of the whole. Don’t strive to be the guy addressing the crowd. Strive to be the crowd. So part of overcoming our depression and anxiety—the first step, and one of the most crucial—is coming together.” And, “Now, when I feel myself starting to slide down, I don’t do something for myself—I try to do something for someone else. I go to see a friend and try to focus very hard on how they are feeling and making them feel better. “I try to do something for my network, or my group—or even try to help strangers who look distressed. “I learned something I wouldn’t have thought was possible at the start. Even if you are in pain, you can almost always make someone else feel a little bit better. Or I would try to channel it into more overt political actions, to make the society better. When I applied this technique, I realized that it often—though not always—stopped the slide downward. It worked much more effectively than trying to build myself up alone.” I think what Johann is saying is that a sense of meaning, purpose, belonging can’t coexist with loneliness.
Psychoanalyst Francis Weller says it another way,
“at some point we have to stop being the one looking for homecoming and be the one offering it.
“As long as I identify as the homeless child who didn’t get welcomed back I need to make a pivot and say ‘I can also, because of that wound find the medicine of welcome’.”
In what way does being of service help you feel more connected?
How have you learned to deliver what Francis calls “the medicine of welcome” to others?
9. Needs are the doorway to the Inner Child, Imagination, Desire and Purpose. James Hillman, the great Jungian psychoanalyst urges us to use our needs–loneliness being one–to explore the depths of our soul. Loneliness, according to Hillman is, like any other need, “a voice that demands to be satisfied”.
We believe that loneliness represents a void that can be filled by something external: a person’s physical presence, or the actions or words of another that fills the space inside. But a need is actually a doorway: to the Inner Child, who opens the door to the imagination. The need represents something much more, not just love but a kind of archetypal, “divine” love. Not just company, but the deep longing to be whole, to unite with “the beyond”. When we feel needy, or lonely, our Inner Child, according to the Jungians, is crying out. It doesn’t just want to complain.
Hillman says, “The intensity of the need reflects the immensity of the world beyond from which it comes.” The child can help us imagine–when we articulate the need, speak it out loud and feel deeply into the body the sensations that that need creates (where do you feel the need? Where do you feel loneliness?), we let it come up fully. We turn towards the child. We can then be specific about the need. What are we fantasizing will fill this loneliness? Who do I want with me? What would they say? What would they do? Are we riding horses in the sunset?
Allowing the images to come.
Allowing the needs to become wants. When we stay with the loneliness long enough, this voice crying to be satisfied, until it becomes a want, something interesting happens. The emptiness of the need, the lack that represents loneliness begins to become filled: with wanting, with desire. The writer DH Lawrence tells us that “Desire is holy”. It is hot, fiery, passionate. It fills us: “I am filled with desire”. It motivates us. It makes things happen. Desire connects us with the beyond. It moves us towards our purpose.
According to Hillman, a fear of desire stands in the way of finding one’s purpose.
We are afraid of the Inner Child: the weakness that being needy represents.
We feel shameful at our weakness, at our neediness. We deny the needs, or try to fill them some other way. Or we criticize ourselves, punishing the child, or ignoring the child.
But what if this deep, existential loneliness, this longing to be united with what “lies beyond” or what lies deeply in our soul is really the doorway to purpose, to fire, to passion, to an integrated and complete psyche.
What if this neediness is not asking to be filled by external factors: parties, social media likes, validation, but with this deeply felt sense of desire that fuels us in the direction of our dreams?
What is the loneliness asking of you?
When you let the loneliness cry out, when you allow it to provide you with images, and when you allow the loneliness to become a want, what does it drive you to do?
What does it fill you with?
What does it inspire you to do next?
10. Getting To Know Yourself. “If you’re lonely when you’re alone, you’re in bad company.”
— Jean-Paul Sartre. Through this series we’ve explored the concept of feeling alone while surrounded by other people, and feeling utterly content while in complete solitude. And, so loneliness isn’t so much about being physically isolated, but in our deeper inner feelings of connection. The Stoics and the Buddhists tell us that, when we feel lonely it’s because we’ve stepped out of the present moment.
We’ve turned our thoughts to what we lack; we’ve identified with our suffering.
And, according to James Hillman and many other thought leaders on the psyche, we’ve decided that the solution to our suffering is located “out there”, in the external world. But no, say the Buddhists, Stoics and other philosophers. The solution to our suffering is internal. It lies within. And so, they say, when you’re lonely, you need to spend even more time alone–getting to know yourself. When we know ourselves, we feel relaxed in our own company. When we know ourselves, we can share ourselves with others when we’re blessed with their company, thus feeling more connected to them and less alone. Perhaps loneliness isn’t being isolated from others—not all the time.
Loneliness is the feeling we have when we’re isolated from our true selves. So, how can we get to know ourselves? The Buddhists say, sit.
Pay attention to your thoughts, your emotions and your body sensations in the present moment.
James Hillman tell us to watch our pain turn into desire, which tells us what the soul deeply wants. This time of year is hard for a lot of us. Add on a global pandemic, and this year is looking like a challenging one for most. Can you spend some quiet time alone with yourself?
Can you watch the feelings of loneliness arise and fall in your body? Can you deliver yourself a little self-compassion? In those private moments of emptiness, say: “Loneliness is here”. “Everybody feels this way sometimes”. “May I be kind to myself”. And, can you say:
I appeared on the Rebel Talk Podcast with Dr. Michelle Peris, ND. Dr. Michelle writes,
“Not a week goes by that I do not discuss mental health with patients in my office. Rates of depression and anxiety are on the rise. So I really wanted to unpack this important topic for you, giving you relevant information and diving deep into interventions that can help optimize mental health. ⠀
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In this episode, Dr. Talia details how our brains work while suffering from depression, anxiety and stress. Her deep knowledge of neuroscience is combined with mindfulness practices and also with microdosing, an approach that consists in taking low doses of psychedelic drugs, such as LSD or psilocybin-containing “magic” mushrooms, in order to prevent and treat symptoms of depression. ⠀
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Dr. Talia talks about mental and physical barriers, that can holds us back from making the changes needed for a healthier and more balanced life. Listen to this podcast and be inspired by this out-of-the-box conversation about neuroscience, mental health and mindfulness.”
In The Myth of Sisyphus, Camus wrote that weariness awakens consciousness, that “Everything begins with consciousness. Nothing is worth anything except through it.”
In the last few months, I’d been weary—sleeping, eating, exercising, commuting, working, preparing for more work, sleeping, and repeat—but I didn’t feel any consciousness awakening, and I still felt like I was waiting for that “everything”, or at least something, to begin.
I wanted to immerse my bare hands in the soil of life—to feel the softness of joy, the moisture of awe, and the cool warmth of peace, between my fingers. I wanted to feel alive: for my soul to urgently thrust itself into each morning, as if the spinning world depended on it.
Instead, I was stuck in traffic.
In the world of natural health junkies, spiritual community dwellers, and backpacking hippies, a Ten-Day Vipassana Retreat is a right of passage. My friends, colleagues and fellow travellers all assured me that the experience changed them. They all reflected on their ten days spent in the woods in silence, sitting for excruciatingly long hours, as catalysts for growth. They’d burned off dead and stagnant parts of their egos, let go of their cravings, and emerged shiny, with a renewed zest for all their lives had to offer.
Listening to their stories, I imagined myself in their places: sitting mute and contemplative in the dark. Through eliminating all input, I expected the Universe (with a capital U, naturally) to reveal rich meaning beneath its monotonous surface. Plus, I heard the food was good.
So, I signed up. A few months later, with a backpack filled with drab clothes and a meditation cushion, I was driving to the Dhamma Torana Vipassana centre, located outside of Barrie, Ontario.
A sleepy hippie greeted me as a I pulled into a virtually empty, gravel parking lot at the entrance to the centre.
I got out of my car and smiled at him, “I’m here for the Vipassana retreat.”
“Yeah, man,” He replied with eyebrows raised, as if searching his brain for what I was referring to. “Hey, though, do you mind parking your car closer to that truck? There’s going to be a lot of us trying to fit in here.”
I looked around for evidence of this meditation-hungry crowd. Instead, there were a handful of cars parked, including a large black pick-up truck and my own.
“Sure,” I said, “Do you mind just watching my bag?”
I squeezed my car up against the truck. Now we were two cars huddled side-by-side in the large, empty lot. It looked ridiculous but, you know, we were a community now.
“I couldn’t lift the bag,” Said the hippie-turned-parking-attendant, half-apologetically. He’d left it on its side in the dirt. The bag contained two pairs of pants, two t-shirts, some shampoo, and meditation cushion. It probably weighed three pounds.
I smiled tightly at him, hoisted the bag onto my shoulder, and made my way to the registration house to get my room key. Then I headed over to the women’s side of the property to find my cabin.
The cabin was a tiny room containing two beds separated by a shower curtain. I was supposed to share with a roommate, but she hadn’t arrived yet.
How do you room with someone you can’t talk to or look at? I prayed that my roommate wouldn’t show up and that I’d get the room to myself.
I put my things away and headed to the dining hall for dinner.
We were told to hand over our electronics, writing materials, and other valuables. I handed over my car keys so that I wouldn’t be tempted to escape. As my things were being placed into bins, I felt like Austin Powers preparing to be cryogenically frozen.
In fact, the retreat centre, while beautiful, had prison-like undertones. Signs declaring “Course Boundary” stopped you from exploring—or going back to the parking lot. Days later I would stare at that sign longingly, dreaming of the freedom represented by my car. Men and women were segregated into completely separate areas of the property. We weren’t allowed to talk and make eye contact once the silence was imposed. We were also told not to bring flashy, tight or flamboyant clothes and so many of use looked like prisoners: heads down, attention turned inwards, clothes dark, loose and drab.
The experience made me realize that, when it comes to vehicles, I wanted something that symbolized that very freedom. That’s why I started looking into trusted services from BlainvilleChrysler. With their wide selection of Jeep models, known for their rugged performance and adventurous spirit, I knew I’d find something that could take me anywhere I wanted to go. The idea of owning a Jeep was more than just about getting from point A to point B—it was about reclaiming that sense of adventure and independence I’d been missing. It felt like the perfect time to make the leap.
Dinner was vegan food. It was good. However, having been a recovering vegan in the past, I wondered if I’d finish the retreat like the parking volunteer, too weak to lift my own three-pound bag.
After dinner we were given a speech on the rules: no talking, texting, touching, making eye contact, gesturing, wearing tight clothing, doing yoga, running, writing, reading, sunbathing, killing (even mosquitos), sex, drugs, rock ‘n’ roll (or any other music, for that matter), alcohol, eating dinner (just some fruit for newbies), and so on. No Phone, no pets, no cigarettes. It was going to be a long ten days.
I couldn’t wait.
I wondered what amazing insights would emerge from these ten days of spacious silence.
It was time for the first meditation, after which we would observe the Nobel Silence. We settled onto our assigned cushions. I had brought my own meditation cushion and saw that others had brought their own supplies too. Many brought intricate contraptions for sitting: meditation benches, special blankets, chairs, back rests, and knee pads. Rather than preparing to sit for an hour, it looked like they were readying themselves to enter the Earth’s orbit.
The meditation started. The teacher of Ten-Day Vipassana retreats, S.N. Goenka, is dead and so instruction is delivered by a series of tapes he’d recorded, presumably, while still alive.
One of the two assistant teachers pressed play and Goenka’s chanting began. Goenka’s would be the only voice I’d really hear for ten entire days, and it had an alarming amount of vocal fry.
I fidgeted throughout the hour of our first meditation. My meditation practice up until that point consisted of daily thirty-minute sits. I don’t think I’d ever sat for an hour. In fact, after twenty minutes, I’d usually experience numbness in both legs that sent me crawling around on all fours painfully trying to restore blood flow. During this first hour I kept crossing and uncrossing my legs. It wasn’t just me; silence in the hall was punctuated by the cacophony of restless shuffling.
Five more minutes of chanting followed by a gong finally signalled the end of my antsy misery. I slowly and silently got up, keeping my eyes inoffensively cast in front of me, and shuffled, among the tribe of other zombies, out of the hall and back to my quarters. It was barely 9 pm, but I flopped exhausted onto my little bed and immediately fell asleep.
The next day, loud gonging heaved me into the pitch-dark early morning. It was 4:15 am. I dressed in the dark, shuffled to the bathroom to brush my teeth, and headed to the meditation hall for the first two-hour meditation of the First Day.
The schedule was terrifying. We were to wake at 4:15 in the morning to sit for the first meditation, two hours, at 4:30. A gong would then signal breakfast for 6:30 am, after which we’d sit for another hour of meditation. Then we were to return to the meditation hall or go to our rooms and sit for two more hours. Lunch was at 11:00 am, followed by another break. Then, four hours of meditation followed by a snack break, where new students were allowed to eat fruit and drink tea. There was no dinner.
After the snack break, was another hour-long meditation, then a discourse where we were to watch Goenka lecturing—the only entertainment of the day. Then more meditation—45 minutes. Bedtime was 9:30 pm. Lights were to be out by 10 pm. With the first wake-up gong sounding at 4:15 in the morning, and nothing to do in the evenings, I doubted that the early bedtime would be a problem.
The first thing I did was count: eleven hours of meditation. Each day I was to spend eleven hours sitting on a cushion, keeping my back straight, and watching my breath. Besides eating, and walking in the forest during breaks, that was to be my life for the next ten days. How was I going to handle this?
“I think you’ll make it to day seven and then decide you’ve had enough,” a skeptical friend had told me before I’d left. I’d been insulted. Now I doubted my own convictions. Day Seven seemed very far away.
Most of my friends had told me that they’d wanted to leave by Day Three.
By Day Two, however, I was done. My legs and back ached and, halfway through the second day, I decided that I couldn’t do another second of meditation. “I can’t do this anymore!” I exclaimed in my head. Besides Goenka’s, the Voice in My Head was the only voice I’d had access to for the last two days. And it happened to be mistaken. I kept on.
During my 32 years on the planet, I don’t believe I’d spent a day without communicating in some way, shape or form with another human being. Since I could put words together, I hadn’t spent a day in silence. Since I could read and write, there wasn’t a day in which I hadn’t engaged with some form of written text.
I missed it. While taking bathroom breaks, I stared intently at the sign outlining the shower rules. I fascinatedly read about using the hair catcher while showering. I read how we were to clean it out after and dump any hairs in the garbage. I studied the rules about drying and squigeeing the shower walls after use. “With Metta,” The notice signed off. With Metta. Withmettawithmettawithmetta. I read the words over and over again. Bathroom reading. It might as well have been War and Peace.
I expected the days to soak me in serene silence. I was wrong. As it turned out, my head was louder than an elementary school cafeteria during lunch hour. But, unlike the lunch break, there was no end to the noise.
“I eat brown food in the morning with brown tea and green food for lunch with green tea,” My inner monologue babbled gaily. It was true: breakfast was always oatmeal and prunes, which I accompanied with black tea. Lunch was a green salad and some soup or curry. I ate it with green tea. “Maybe I can be vegan,” The Voice in My Head chattered, optimistically, “The food here is so good. I could eat like this all the time. I don’t even miss dinner! Maybe I should start doing more intermittent fasting. I wonder if they sell a recipe book, oh, I can’t wait for breakfast tomorrow morning!”
And, “What colour pants am I going to wear tomorrow? The brown ones or the black ones? Brown or black? Black or brown? Should I wear the brown ones with the white shirt and the black ones with the blue shirt? Or the blue ones with the—” I’ll spare you the rest.
I had entire conversations with people in my head. I wrote, rewrote, and edited monologues, conversations and imaginary dramas. I crafted responses from the characters I was arguing with. I practiced my lines and honed them.
I humbly discovered that it was not a chaotic world, filled with sensory distractions, that stifled some creative genius locked somewhere within; the chaos was removed and no genius emerged. Instead, when left to its own devices, my mind became a shallow simpleton bouncing senselessly to topics like the clothes I was wearing, the things I was eating, and people I was dating. How disappointing.
During the eleven hours of meditation, my mind and body rebelled. Every itch, twitch and irritation, mental or physical, would send me crossing and uncrossing my legs, refolding my hands, opening my eyes, and stretching my neck—anything to avoid actually meditating.
My only reprieve was meal times. I would wait for them, like Pavlov’s dog, salivating in anticipation of the gong that would release me from the hell of sitting.
On Day Three, however, I noticed something different. I was sitting in meditation and I wanted to move: do something, like cross my legs a different way. I felt tension and frustration rise within as I resisted the urge. The resistance was like a boulder to push against. It had edges, viscosity. I couldn’t push anymore. I relaxed, softened. I opened.
And with that, the resistance popped. I felt immediate relief.
It was as if my mind and body were wrapped in a crumpled fabric. Each knot and wrinkle resembled an agitation, a restlessness, a mania that arose from within my physical and emotional self. Pushing up against these wrinkles would only tighten them, causing more agitation. But, when I began to breathe, to dissolve their solidity, they began to soften, and pop, like bubble wrap. The fabric began to iron out. I was calm.
I started to notice bigger knots: my relationship with uncertainty, for instance, that seemed too monstrous to pop, however the mini bubbles of impatience started to disappear as they arose, one by one.
Openness.
Openness provides relief from suffering.
Maybe I could survive this.
On Day Three Impatience and I got to know each other. Impatience has been a theme in my life, a low-level agitation that manifests in restlessness: my desire to connect on social media, to distract with technology and day-dreaming, to tweeze hairs and do dishes instead of doing work, and to lurch through life with my head pushed forward, oblivious to my surroundings.
I moved through life like I ate: inhaling a fresh spoonful before swallowing the first. I wasn’t tasting my food. I wasn’t tasting life.
During one particularly turbulent moment in meditation, when a wave of impatience hit, so did a series of images: family weddings, babies being born, pets passing away, family members passing: images of events that had not yet occurred, but almost certainly would. I was racing towards the future, which would bring me both wonderful experiences and inevitable pain. And, of course, at the end of it all would be the end of me. What was the rush?
I brought my attention back to my breath. Some more knots in my mind’s fabric opened.
On Day Four I recognized that, at the heart of this impatience was a craving for certainty. Underneath that craving: fear.
What I am afraid of? I asked the blackness.
Almost immediately, from some depths of my psyche, the answer surfaced.
I’m afraid to suffer.
Suffering, the Buddha’s first Nobel Truth. Life is suffering, or Dukkha. Like every other being who had ever lived, as long as I was alive I would suffer. If I craved certainty, then this was it.
We began to practice Vipassana on Day Four. For the past three days, my entire world had been reduced to the rim of my nostrils where my breath passed. The technique of focussing on the breath at the nostrils is called Anapana, and its goal is to sharpen and focus the mind.
Vipassana, or the development of equanimity regarding the impermanence of nature, and the truth of suffering, focusses on body sensations. We first began to scan the body from the tips of the toes to the top of the head (“Staaart from. the. topofthehead. Top of. Thehead,” Chirped Goenka’s voice on the recordings), a relatively simple technique in theory that proved to be excruciating in practice.
If the first few days had introduced me to the manifest agitations and disquiets in my body and mind, Day Four presented me with the full-on war raging within. For three hours a day we were to resist the urge to move. My body was on fire.
Demons in my head commanded me to move, get up, scream. Others shouted at me to stay still. Still others urged me to quit. Amidst their shouts was harrowing physical misery.
I felt like I was under the Cruciatus Curse. In fact, the whole retreat was starting to seem like a JK Rowling novel, or some other Hero’s Journey. I had set out to conquer evil only to find that all evil came from within, and was now being asked to face it bravely, conjuring up a Patronus of equanimity to protect me from being consumed by this hellish fire.
“The only difference between a Ten-Day Silent Vipassana Retreat and a Harry Potter novel is that ‘He Who Must Not Be Named’ is literally everything,” I thought, sardonically.
From Days Four to Five, I emerged from every sitting broken and exhausted. Being on Day Five was like reaching the middle of a claustrophobic tunnel. I was halfway through and still had just as far to go. I scanned the deadpan faces of the crowd during mealtimes to see if anyone else had spent the last hour being electrocuted.
Goenka said the sensations of fire and electricity were Sankaras, mental cravings that embed themselves in our physical bodies and cause suffering. An intense sensation was simply one of these Sankaras floating to the surface of the body. If we met it with “perfect equanimity”, it would be eradicated, and we would be cleared out for our next incarnation.
These body sensations—the sharp, twitching, numb, searing, blinding, and even pleasurable— were a representation of nature itself. Sensations arise in the body and pass away; they are impermanent, Anitya. Through first being aware of them, and then meeting them with openness, without clinging or aversion, we can be free from suffering.
“Maintain perrrrrrfect equanimity. Perrrrrrfect equanimity, with the understanding of Anitya.
“Anitya…. Anitya….” Goenka’s recordings crooned.
Sapiens author Yuval Noah Harari, also a long-time Vipassana practitioner, states, “Meditation is about getting to know the most ordinary, daily, natural patterns of the mind, body and emotions, to observe reality as it is. If you can observe, to some degree, reality as it is, without running away to stories and fictions, you will be a more peaceful and happy person.”
Well, I certainly wasn’t happy.
On Day Five I was being burned at the stake. Someone had lodged a red hot poker into my right flank, just to mess with me. “I will never be able to walk again,” My mind blabbered, “This is torture. I’m becoming permanently injured. I can feel the meniscus in my knees slowly tearing—“
Goenka’s chanting began, indicating we had five more minutes of this hell. I relaxed, even though we still had five more minutes of this hell. The mind is a ridiculous thing.
—Donnnnng….
Freed by the beautiful, beautiful music of the gong, I sprang up. I expected to hobble, in pain, clutching at my back, working out stiffness in my knees. I anticipated the inevitable sharp pain that would appear in my ankles as I took my first step.
Yet, as I walked out of the meditation hall to stand in the July sun, I noticed that there was not a twinge of pain, a tightness, nor an ache to be found. My body felt perfectly fine. On the contrary, I actually felt great: light and supple. It felt like I was floating.
Hm.
By the time Day Six arrived, I was greeting the pain like an old friend. I noticed that discomfort came, not from the sensations themselves, but from the mind’s anticipation of and resistance to them. If I expected an arising sensation to be painful, I would brace myself against it, creating tension. And, after the sensation had faded, my mind would still grip it, creating a story of aversion.
So, I stopped calling it pain. Instead, it was a series of sensations: numbness, vibration, tingling, spark, heat, radiation, burning, but not pain. I noticed the sensations that disappeared as soon as they materialized, like shooting stars across my back. Others were solid, like clumps of cement hanging out in my body for the entire hour. I now easily sat for an hour without moving, watching this orchestra of sensations transpire across my flesh.
The war was ending. I was winning.
I was free.
Four days to go.
Anitya.
Sometimes impermanence isn’t fast enough.
On Day Seven, I settled into meditation, welcoming it now. I dropped into my breath, and began practicing Vipassana, sweeping my attention over my body, observing the sensations that were present, just as Goenka instructed.
Curiously, the sensations dissolved. There was no sensation, there were no Sankaras, there was no body. I could still feel the line where my lips met, and where my hands came together in my lap. Other than these two black outlines drawn in space, I had dissolved into ether, the atoms of my body emitting a subtle vibration that merged with those that surrounded it.
It wasn’t surprising. For the last seven days I’d been eating oatmeal and meditating in the woods without speaking to anyone. Now my entire body was evaporating. Nothing was surprising anymore.
I later learned that this phenomenon was called a “Free Flow”. It results from absolute openness: from a mind that is both equanimous and subtle. Solidity dissolves, and what is left is the vibration of atoms, all transient, anitya. All impersonal, Anatta.
The Three Buddhist Marks: Anitya, Anatta, Dukkha.
Impermanence, Non-Self, Suffering.
Now that I was One with, whatever it was I was one with, I figured I might as well seek some spiritual answers. Or at least make a wish or something.
I thought of what I most wanted in the world. “I want connection,” I told the Universe, “I want deep, connected relationship.”
Amidst the vibrations, something answered. A simple, Why?
Hm. Why, indeed? I’d never entertained the question.
I want to be loved, emerged my answer, from I-didn’t-know-exactly-where, since I was currently nothing. It was like my heart was speaking instead of my head. The utterance arose out of space, before dissipating, like smoke rings from a caterpillar’s hookah. Then, there was silence.
The energy, or entity, or my Higher Self, whoever I was talking to, seemed amused at my naivety. I could feel her compassionate chuckle vibrating into the atoms that buzzed where my body had once sat.
You already are,
the amused response manifested from the darkness into which I was dispersed.
You already are.
And, at that moment, nothing seemed more true. Nothing can give us what is already in our basic nature.
Self-compassion is the act of treating yourself as you would any other loved one: treating yourself with kindness vs. Self-Judgment.
Self compassion is a modality that is being researched for treatments for mental health conditions, preventing burnout, improving motivation, body image, resilience, and in clinical settings for the helping professions.
The leading expert on self-compassion, Kristen Neff, PhD, defines self-compassion in three ways:
Mindfulness
Invoking a sense of common humanity
Self-acceptance vs. self-judgement
This 3 minute self compassion break can be done in a moment of difficulty, such as in the presence of strong emotions, physical sensations, self-criticizing thoughts, or in the face of failure. It can be done on a daily basis or when difficulty is present.
Step 1:
Adopt a posture that invokes a sense of self compassion. The posture to adopt is traditionally placing hands on the heart, but can also be hands placed on the neck, or a mudra. Touch releases oxytocin, our “love hormone” which releases feelings of calm, love and connection, even when it’s our own hands being placed on our own body.
Step 2:
Either to yourself, or out loud, say these three sentences.
This is a moment of suffering. This is mindfulness, acknowledging that suffering is present and turning towards, as opposed to turning away from difficulty.
Suffering is a part of life. Other alternatives to this are: other people feel this way. This is invoking the sense of common humanity, reminding yourself that you are not alone and other people on earth have felt or are currently feeling this way.
May I give myself the compassion I need. This is setting an intention to be kinder to oneself. Other alternatives are: may I be kind to myself, or may I try to accept myself as I am.
For more on Self-Compassion, to access more of Kirsten Neff’s research, and for free resources, visit selfcompassion.org
In order to make sense of the world, people create stories. It is our greatest gift and most fragile weakness.
Boy meets girl, they fall in love, they encounter difficulties that they eventually overcome. It brings them closer. They live happily ever after—the classic love story.
Stress has a classic story too: cortisol, the “stress” hormone, is released during stress. It wreaks havoc on the body. Lowering stress helps lower cortisol.
However, when it comes to human hormones, telling stories in a linear narrative is impossible.
Hormones are signalling molecules in the body. They are produced by endocrine organs, such as the adrenal glands, the brain, and the ovaries. They travel through the bloodstream to impact the expression of genes on distant tissues, which impacts how our bodies function.
Production of norepinephrine in the adrenal glands as a response to stress can make your heart race, your pupils dilate, your hands to shake, and your senses become hypervigilant—when a perceived threat or danger activates the release of this hormone, your entire body pulsates under its influence.
Hormonal stories are hard to fit the human desire for narratives. Their relationships with our genes, bodily systems, receptor binding sites, and each other make their actions too complicated to be described linearly. Instead they act like webs, or tangled networks of intricate connections.
When hormone levels rise in the body, beyond our delicate homeostatic balance, a phenomenon, called “resistance”, can occur. With resistance, cells reduce their responses to the hormones that interact with them.
When telemarketers keep interrupting your dinner at 6pm, eventually you stop answering the phone.
When certain hormones continue to call at the surface of cells, stressing the body’s capacity to respond, our cells simply stop answering.
Many of us ask, “what happens when I pull this thread here?” when learning about one hormone that we’ve blamed all our woes on. We tug the thread, without considering the entire web of connections, and our actions affect the entire system.
Our hormones exist in an ecosystem where everything hums and flows together, as a unit. It’s impossible to lay out explanations for their actions in a linear fashion.
Hormone stories flow like a Choose Your Own Adventure novel—a hallway with many doors that snake down long corridors and meet again, and interconnect.
Go through the door marked “estrogens”, and you encounter serotonin, cortisol, progesterone, insulin, thyroid hormones, leptin, BDNF, dopamine, norepinephrine, and many others.
Hormones are the conductors of your body’s personal orchestra, composed of thousands of musicians, a complex musical score, highly-trained arms, fingers, and mouths manipulating instruments: a million moving parts working together in harmony.
The best we can do to understand the entire interplay is to slow down the action, take a snapshot of it, and to try to understand why these symptoms are occurring in this individual.
Symptoms of Hormone Imbalances
Because hormones affect absolutely every system of our body, I am always attuned to the possibility of hormonal imbalances in my patients.
It helps to look at hormones in terms of their symptom patterns rather than how any one hormone affects us in particular.
Common signs of hormonal imbalance are:
Fatigue, low libido, restless sleep, depression and anxiety, waking at 2 to 4 am, a high-stress lifestyle, and brain fog might indicate cortisol imbalance.
PMS – and the more severe related condition, PMDD – infertility, fatigue and low libido, missed and irregular periods may be related to fluctuations in the hormones estrogen and progesterone, or low estrogen and progesterone levels. Many of these symptoms could also be related to estrogen dominance, in which estrogen is either high or normal, and progesterone is low.
Endometriosis, a family or personal history of female cancers, anxiety and panic attacks, heavy and painful periods, frequent miscarriages, infertility, fibroids, fibrocystic breasts and weight gain around the hips and thighs can indicate estrogen dominance.
High levels of male sex hormones like testosterone, irregular periods, weight gain, acne, and hair loss may indicate a female hormone condition called PCOS.
Fatigue, brain fog, difficulty losing weight, puffiness, constipation, dry skin and hair, and low body temperature can be signs of hypothyroidism.
Symptoms of reactive hypoglycemia, such as feeling dizzy, anxious and shaky between meals, sugar cravings, weight gain around the abdomen, difficulty losing weight, and low morning appetite, night-time carbohydrate cravings, and binge eating can all be related to insulin resistance and poor blood sugar control.
In my naturopathic practice, I see common patterns of symptoms that indicate certain hormonal imbalances.
These patterns often represent vicious cycles where our body is stressed beyond a capacity to balance these interconnected webs of chemical interactions, causing further imbalance.
Cortisol
Speaking of stories, here’s one I hear often.
You wake up in the morning, exhausted. Your brain is in a fog and you don’t feel alive until a cold shower or double espresso knock you out of your stupor.
Things get a bit better once you get moving, but you wonder why your energy never fully bounces back.
You used to play sports in university, you think to yourself. Now just thinking of sports makes you tired.
Is this what getting older feels like? You’re in your 30s.
The days at the office stretch on forever. Concentration and focus are difficult. You see a coworker whose name, you realize with horror, can’t be brought to mind.
You’ve known her for a year. Cynthia? Sylvia? Your brain hurts.
In the afternoon you think longingly of napping, but instead take your place in the long line for coffee and something carb-y like a cookie.
When it comes time for sleep you are either out like a light or find it hard to turn your mind off; you’re tired, as always, but also wired.
Sleep doesn’t feel restful, and you often wake up, sleepless, at 2-4am in the morning.
When your alarm rings a few hours later, the cycle begins again.
Cortisol, one of our stress hormones, has a circadian rhythm. Its levels are highest in the morning, about an hour after waking. Cortisol promotes energy, alertness and focus. It is also a potent anti-inflammatory hormone.
Cortisol is what makes us feel alive in the morning, bouncing out of bed like Shirley Temple and her curls.
Throughout the day our cortisol levels slowly dwindle (unless a major stressor causes them to spike abnormally). They are lowest in the evening, when melatonin, our sleep hormone begins to rise, inducing feelings of sleepiness, preparing us for a night of rest.
Our modern day society, however, calls on cortisol to perform more than its fair share of work. Cortisol is around when we’re hauling ourselves out of bed after an inadequate night of rest.
Cortisol fuels gym workouts, gets us to our meetings on time, allows us to meet deadlines, tolerates traffic jams, responds kindly to tyrannical bosses, and makes sure the kids get to all their after-school events.
Cortisol is made in the adrenal glands, two endocrine glands located on each kidney, in response to signals from the brain that perceive stress in our environments and bodies.
When stress hormones levels are too high we experience a “tired and wired” feeling. During this time we might feel we thrive better under stress: workouts boost our energy, we have a hard time quieting down and we rarely feel hungry.
We might still struggle with weight gain, however, especially the abdomen and face, where cortisol tends to encourage fat deposition.
We might feel tension—tight muscles and shoulders, and body pain, as muscles clench up, preparing to fight or flee.
Chronic stress is associated with high levels of cortisol. We work long hours, late into the night. We go, go, go. This may give us a “high” or it may feel exhausting and depleting.
Many of us can exist in this state for months and even years. Sometimes a compounded stressor such as a divorce, accident, or loss, can tip us over the edge into a depleted, burnt out state.
Burnout, often following a period of prolonged stress, can be associated with low cortisol signalling. Our bodies have simply stopped being able to produce the stress hormones necessary to meet the needs of our daily lives, or glucocorticoid receptors in the brain and body cells, have stopped responding to cortisol.
Just as cell can be become resistant to insulin, they can also become resistant to cortisol. Too much (or even too little) of a hormone can cause cells to start ignoring their signalling, resulting in symptoms of low levels of the hormone in some areas of the body and high levels of the hormone in others.
Cortisol is a complicated molecule. It both encourages the stress response, but also turns it off, when levels reach a certain point.
Often, cortisol levels that are too low result in an impaired stress response, preventing our fight or flight system from properly shutting off—cortisol resistance can lead to further stress hormone disruption.
The result of an imbalance in cortisol, otherwise termed Hypothalamic Pituitary Adrenal (HPA) Axis dysregulation is weight gain, fatigue and brain fog, inflammation and immune system activation, digestive issues, restlessness, impaired sleep, decreased cognitive function, and mental health conditions, such as anxiety and depression.
When cortisol levels are low, the body makes adrenaline and noradrenaline to meet our needs, which often leads to anxiety and feeling shaky and nervous, contributing to symptoms of anxiety.
Cortisol also influences the function of our sex hormones, thyroid hormones, and our blood sugar. Imbalances in any of these other hormonal systems can be a result of an impaired HPA axis.
Cortisol Testing
The two main ways to assess the body’s levels of cortisol are through serum (blood tests) and saliva.
A study found both tests were equal when it came to diagnosing Cushing’s disease, a condition of highly elevated cortisol.
One of the advantages to salivary cortisol testing is the ability to obtain multiple samples in one day to be able to view a patient’s cortisol curve, in which cortisol peaks approximately one hour after waking and declines throughout the day.
The cortisol curve is measured by assessing 4 samples of salivary cortisol taken at 4 key points during the course of one day. It measures free cortisol, which may only represent about 5% of total cortisol in the body.
While salivary cortisol levels can be a good starting point for assessing the cortisol curve, it doesn’t tell us everything about the health of the glucocorticoid receptors or HPA system as a whole.
High cortisol levels may be seen in patients with low cortisol signalling, such as depression, anxiety and chronic fatigue. Errors in obtaining salivary cortisol samples (such as not taking samples at the right time) can lead to falsely low cortisol readings.
In my opinion, this makes symptoms and health history the most valuable tools for properly assessing HPA axis function.
Cortisol and Melatonin
Melatonin, our sleep hormone, also operates on a circadian rhythm. It is released by the pineal gland in the brain and induces sleep. Its release corresponds to a drop in cortisol levels at the end of the day.
That release is impeded by artificial light exposure at night, lack of daytime sun exposure, alcohol, stress, and HPA axis disruption, among other lifestyle and environmental factors.
Melatonin, like other hormones, can be tested for in blood, urine and saliva, but I find more value in assessing for sleep quality and quantity by taking a thorough health history while also restoring a patient’s sleep hygiene and HPA axis regulation.
Many patients with sleep issues can benefit from a trial of supplemental melatonin to see if that helps their sleep. Taking it 2 to 3 hours before bedtime to coincide with the body’s natural melatonin surge and taking a prolonged-release version to promote sleep maintenance are two strategies I use for helping patients sleep better.
Working on sleep and circadian rhythms is also beneficial for restoring HPA axis functioning.
The “Female” Hormones: Estrogen and Progesterone
The most prevalent female sex hormones are estrogen and progesterone. These two hormones eb and flow in distinct ways throughout a woman’s monthly cycle.
Estrogen creates an “M” shape, rising at the beginning of the cycle to its first peak around ovulation, half-way through the cycle. At this time women typically experience their best mood, energy, and motivation, perhaps noticing a rise in libido.
After ovulation, estrogen dips a little bit and then rises, peaking again about a week before a woman’s menstrual cycle is due.
After this, estrogen takes a nosedive, reaching low levels around the time that menstruation begins: Day 1 of the menstrual cycle.
Progesterone, on the other hand is largely absent the first half of the cycle, before ovulation. Then, it begins a steady climb to peak with estrogen, about a week before the arrival of the next period.
After peaking, just like estrogen, progesterone then takes a dip, which stimulates the uterine lining to shed, resulting in menstruation, in which the entire cycle begins again.
PMS and PMDD
My practice is populated by women who experience various forms of grief at different stages of their monthly cycles.
Many of my patients experience PMS, and the more severe PMDD (Premenstrual Dysphoric Disorder)—which is characterized by intense mood swings, irritability, depression, or anxiety, panic attacks and psychosis in the most severe cases— up to two weeks before their periods.
The mood changes in PMS and PMDD are associated with fluctuations in the hormones estrogen and progesterone, which can wreak havoc on our brain chemistry.
Estrogen has a beneficial effect on mood, increasing dopamine and serotonin action in the brain. Dopamine and serotonin are two antidepressant, feel-good neurotransmitters.
Estrogen also increases something called Brain-Derived Neurotrophic Factor (BDNF) a chemical that stimulates the growth of brain cells. This can boost memory, concentration, and cognition, as well as positively influence mood.
Progesterone breaks down into a chemical called allo-pregnenolone, which acts like GABA, a calming neurotransmitter, in the brain. Bioidentical progesterone therapy is often used as a treatment for anxiety and insomnia.
When estrogen and progesterone levels surge and drop suddenly, drastic fluctuations in mood can occur. Cravings for sweets, crying, lack of motivation, or severe anxiety can all occur when hormones drop right before a period is due.
However, elevated levels of estrogen can also be problematic. Estrogen stimulates dopamine, which typically makes us feel good, gives us energy, and helps to motivate us. In genetically vulnerable women, elevated levels of dopamine can cause excess irritability, low stress tolerance, and even mania or psychosis.
Estrogen also slows the recycling of the stress hormones epinephrine and norepinephrine, which can lead to symptoms of acute stress and anxiety, when dysregulated.
This means that dramatic rises and falls in estrogen throughout a woman’s cycle can cause her to feel irritable and anxious one week and unmotivated and depressed the other.
Smoothing out hormonal ups and downs can be a key factor in regulating a woman’s menstrual cycles and soothing her mood and emotions throughout the month.
Perimenopause and Menopause
Perimenopause is characterized by a declining production of the ovarian hormones estrogen and progesterone.
Estrogen levels tend to rise and fall dramatically throughout a woman’s remaining cycles, while progesterone levels tend to stay low.
The result of these changes are symptoms like hot flashes, night sweats, brain fog, fatigue, and depression when estrogen levels suddenly tank, and increased stress and anxiety when estrogen levels abruptly spike.
During this time, cycles may become irregular. Some of my patients comment that their periods are incredibly light one month and the heaviest of their lives another.
Some get periods every few months and some notice increased frequency, even spotting between cycles, or have a full-blown period every two weeks in more extreme cases.
Weight gain tends to drift from the thighs and buttocks to the abdomen. Once pear and hourglass-shaped figures begin to resemble apples.
Fatigue is a common symptom. Women may experience poor sleep due to night sweats from estrogen deficiency, and anxiety from insufficient progesterone.
What a joy, right?
Many of these perimenopausal symptoms are a relatively modern phenomenon, stemming from a dysregulated HPA axis.
After cessation of periods, it’s the job of the adrenal glands to take over sex hormone production. However, if the HPA system is preoccupied with organizing a stress response, this can affect the production of other hormones.
Impaired Estrogen Clearance
Many women struggle with symptoms that are related to relatively high levels of estrogen, often caused by impaired estrogen clearance.
These conditions include heavy and painful periods, fibrocystic breasts, or conditions like fibroids or endometriosis.
Chronically elevated estrogen levels also include a risk of certain hormone-associated cancers, such as breast cancer.
These women may experience irritability and anxiety through estrogen’s interaction with stress hormones, and also from a relative deficiency in progesterone.
A relatively high level of estrogens compared to progesterone is termed “Estrogen Dominance”.
Estrogen is normally cleared through the digestive system: the liver and intestines.
A sluggish and congested liver causing a slower rate of hormonal clearance (think of it like a clogged drain), an increase in environmental toxin exposure, or an overconsumption of alcohol, can slow the liver’s ability to regulate estrogen levels in the body.
Constipation and a dysbiotic gut can also impair estrogen clearance.
Symptoms of estrogen dominance include stubborn weight gain, typically around the hips and thighs, heavy and painful periods, tender and painful breasts, fibrocystic breasts, endometriosis, uterine fibroids, acne, cyclical mood swings, especially premenstrual anxiety and panic attacks, and irregular menstrual cycles.
Low Progesterone
Aside from impaired estrogen clearance, another pattern of estrogen dominance is low progesterone.
In this case, estrogen levels are normal or even low (as in the case of menopausal or perimenopausal women). However, an even lower progesterone level still results in a pattern of relative estrogen dominance.
This can cause some of the same symptoms as excess estrogen (anxiety, irritability, heavy and painful periods, weight gain, PMS, fibroids, fibrocystic breasts, etc.).
Low progesterone can also be a culprit in unexplained infertility or early term miscarriage, as progesterone maintains the uterine lining in pregnancy.
Progesterone is released from the ovaries after ovulation. Lack of ovulation, therefore, is a primary reason for low progesterone levels. Anovulatory cycles can occur in women with polycystic ovarian syndrome, women with high levels of physical and emotional stress, or women entering menopause.
Some progesterone, however, is also made in the adrenal glands, where it can be eventually turned into cortisol, aldosterone (a steroid hormone involved in salt-water balance in the body) and androstenedione (a male sex hormone), eventually making testosterone and estrogen.
Women with high cortisol demands due to chronic stress may shunt the progesterone made in their adrenal glands to producing other hormones that support the stress response.
Not only can stress alter ovulation and fertility through various other mechanisms, it can also rob the body of progesterone, directing any progesterone made towards cortisol production.
Testing Estrogen and Progesterone
Estrogen and progesterone can be tested reliably in saliva, blood and urine.
Month long salivary hormone testing of estrogen and progesterone can be an easy and effective way to track the eb and flow of these hormones throughout a women’s menstrual cycles.
In this test, women obtain a saliva sample every 3 to 5 days for the duration of the month to track how estrogen levels corresponds with progesterone and how both hormones rise and fall.
In my practice, however, I often start by running blood tests. I test hormones on day 21 (of a 28-day cycle) to coincide with progesterone’s peak. This can help us calculate the progesterone to estrogen ratio and establish whether the cause of estrogen dominance symptoms is high estrogen or low progesterone.
Blood tests offer the option of looking at estrone, which is a more problematic form of estrogen, as well as estradiol (the most common, metabolically active estrogen in the body). In blood we can also look at LH and FSH, two hormones produced in the brain and ovaries that orchestrate ovulation.
FSH tends to be high in women in menopause or perimenopause, while LH tends to be elevated in women with Polycystic Ovarian Syndrome (PCOS).
Dried urinary metabolite testing, or DUTCH, is an effective way to understand how hormones are broken down and processed by the body. Looking at the entire hormone breakdown pathway provides a more in-depth look at the complexity of hormones in a woman’s cycle, and can guide treatment in specific, useful ways.
The “Male” Hormones: Testosterone
Polycystic Ovarian Syndrome (PCOS) is one of the most common causes of infertility (and the most common endocrine disorder) in women of reproductive age. It affects about 10% of menstruating women.
PCOS is a collection of various symptoms and complex hormonal causes. However, it is characterized by missed periods, anovulation, male-pattern facial hair growth, especially on the upper lip, chin, breasts and abdomen, and the presence of cysts on the ovaries.
Other common symptoms of PCOS are weight gain, estrogen dominance, male-pattern hair loss (on the crown of the head), insulin resistance, infertility, and acne, especially hormonal cystic acne on the jawline.
PCOS is characterized by elevated levels of testosterone, a male sex hormone, or “androgen”, on blood work.
Acne, weight gain, infertility, and hair loss are the main symptoms that bring women with PCOS into my office.
PCOS is a complex process that involves an overproduction of testosterone in the ovaries coupled with insulin resistance. Therefore, balancing blood sugar through diet and lifestyle can have a major impact on symptoms.
The conventional treatment for missed or absent periods is oral contraceptives, which of course doesn’t treat the underlying cause of anovulation. That’s why women with PCOS often seek naturopathic and functional medical solutions to treat the root cause.
Testing for PCOS
When I meet a new patient with PCOS, I often test her blood for estradiol and progesterone levels at Day 21 of her cycle. A very low progesterone level may indicate that she has not ovulated that cycle.
We also test LH and FSH. A high LH:FSH ratio can be indicative of PCOS even if cysts are not present on an ovarian ultrasound.
Other important tests that are often ordered are free testosterone and DHEA-S, another male hormone made in the adrenal glands.
Glucose control and insulin resistance can be assessed by looking at fasting blood glucose, fasting insulin and HbA1c (a marker that looks at long-term glucose control).
Prolactin, another hormone released by the pituitary gland, can sometimes be elevated in anovulatory women with PCOS.
A 4-point salivary cortisol test may be useful in women with PCOS who are also experiencing symptoms of cortisol dysregulation, which can contribute to insulin resistance and affect ovulation and hormone regulation, particularly progesterone production.
Prolactin
Prolactin is a hormone released by the pituitary gland to promote milk production after child birth.
However, some women will have elevated levels of prolactin in blood, despite not currently pregnant or breastfeeding.
Called hyperprolactinemia, elevated prolactin may be a cause of anovulation, mimicking some symptoms of PCOS and menopause, including hot flashes, absent or irregular periods, infertility and even milk discharge from the breasts.
Hyperprolactinemia may be caused by low calorie diets, liver issues, hypothyroidism, and issues with the pituitary gland itself.
Prolactin can be tested in blood. If levels are elevated, an MRI must be conducted to rule out a physical issue with the pituitary gland, such as a tumour.
Oxytocin
Oxytocin is a hormone produced in the brain and secreted by the pituitary. It aids in childbirth. Also termed the “love hormone,” it’s associated with feelings of intimacy and connection.
While high and low levels of blood oxytocin can be possible in men and women who are not pregnant or breastfeeding, the clinical applications of it are not fully known.
Thyroid Hormones
The thyroid, a butterfly-shaped gland on our neck, is the master thermostat of the body, controlling heat and metabolism. It pumps out thyroid hormones T4 and T3, which tell cells to burn fuel, creating energy and heat.
Because our thyroid hormones interact with the cells in every body system, symptoms of hypothyroidism, or low thyroid function, can be incredibly diverse.
Common symptoms of hypothyroidism are weight gain or inability to lose weight, fatigue and sluggishness, brain fog, hair loss, low body temperature, constipation, dry skin and hair, puffiness, infertility, and altered menstrual cycles, such as missed periods or heavy periods.
Aside from autoimmunity, other causes of low thyroid function can be HPA axis dysregulation and chronic stress, a very low calorie or very low carbohydrate diet, sudden weight loss, a deficiency in nutrients needed for thyroid function such as iron, zinc, iodine and selenium, and a body burden of environmental toxins such as heavy metals.
Testing Thyroid
To assess thyroid function, conventional doctors will test a hormone called Thyroid Stimulating Hormone, or TSH. TSH is not a thyroid hormone, but a hormone made in the brain that urges the thyroid to pump out the thyroid hormones T3 and T4. It gives doctors an indirect measure of thyroid regulation.
When TSH levels are high, this suggests that thyroid function is sluggish; the brain needs to send a louder signal to get an unresponsive thyroid to work.
However, TSH is only a periphery marker of total thyroid function, not giving us the whole picture. Also, TSH ranges on conventional lab tests may fail to pick up some cases of subclinical hypothyroidism or impending cases of autoimmune thyroid conditions, otherwise termed Hashimoto’s Thyroiditis, which is the most common cause of hypothyroidism.
To properly assess thyroid function in someone with symptoms of thyroid dysfunction, a slightly elevated TSH, or a family history of Hashimoto’s, I will order a thyroid panel: a blood test measuring TSH as well free thyroid hormone (T3 and T4) levels.
It’s also important to assess for autoimmune thyroid conditions by testing for anti-thyroglobulin and anti-thyroperoxidase antibodies. Both of these antibodies, when elevated, suggest the presence of an autoimmune thyroid condition.
Insulin
Some of the most common hormonal dysfunctions I see in my practice are insulin resistance and reactive hypoglycemia: blood sugar imbalance.
These issues often lie at the heart of other hormonal imbalance patterns, such as irregular menstrual cycles or HPA axis dysregulation.
When we eat, glucose enters our bloodstream, providing fuel for our cells. Insulin helps our cells access this hormone, spiking with each meal.
The higher the meal is on the glycemic index (i.e. the more sugar or refined carbohydrate it contains), the higher our post-meal blood sugar and insulin spikes will be.
Without insulin, we would slowly lose energy and die, unable to get precious glucose into our cells. Individuals with type I diabetes cannot make insulin. They must inject it daily to keep their cells fuelled and blood sugar stable.
For the rest of us who do make insulin, large blood sugar spikes after a meal can be problematic.
Insulin is a storage hormone. It helps energy get into cells, and it helps build muscle and brain cells, but it also blocks the breakdown of fat cells, blocking weight loss.
Insulin also drives down blood sugar levels. When blood sugar rises too quickly after a meal, a large insulin response can drop blood sugar levels too drastically, causing reactive hypoglycemia, or feeling “hangry” (hungry, angry, irritable, tired, light-headed, weak and dizzy) in between meals.
Individuals who experience hypoglycemia feel irritable, shaky, dizzy and anxious between meals. They often suffer from anxiety and panic attacks, and feel hungrier at night.
They may wake up in the middle of the night, as their bodies are unable to go 8 hours (the length of a decent night’s sleep) without food. This causes them to wake up, restless and perhaps anxious, in the early hours of the morning.
These individuals, paradoxically, rarely feel hungry at breakfast time.
I often see anxious patients wake from a restless sleep and toss back only a coffee in the morning, skipping breakfast due to slight morning nausea.
At 10 am, feeling ravenous and shaky, they might scarf down a high-glycemic bagel or croissant. Later on, they’ll enjoy a light lunch—maybe a sandwich—often feeling foggy and lightheaded after eating it.
At 2 to 4 pm, they may feel like an afternoon nap, instead indulging in a coffee and sweet treat to buy them some energy for the remaining hours of the work day.
Finally, after enjoying a larger dinner once they get home, they find themselves snacking all night long. Their bodies are finally urging them to ingest the nutrients they were lacking throughout the day.
They then fall into bed, feeling full, restless and wired, and the cycle begins again.
When our blood sugar falls, we not only feel hangry, weak, and crave processed carbs, our HPA axis also gets stimulated.
Cortisol, a glucocorticoid, can help our body control blood sugar, bringing it into the normal range after insulin sends it tanking too low.
This drop in blood sugar, therefore, needlessly triggers a stress response from the adrenal glands, which can further worsen anxiety, HPA axis dysregulation, and glucocorticoid resistance.
When blood sugar and insulin are spiked repeatedly for days, months, and years on end, cells stop responding attentively to insulin’s signal. Like our response to a pesky telemarketer, cells eventually stop picking up the phone when insulin calls.
However, cells still need insulin. More and more insulin must be released to trigger the same response from insulin resistant cells. This makes cells even more resistant, as they require even more insulin release the next time blood sugar rises to get glucose into the cell for fuel. And so the cycle becomes vicious.
Elevated insulin levels cause inflammation, fat gain, fatigue, depression, reactive hypoglycemia, and HPA axis dysregulation. The more resistant our cells become to insulin, the more cortisol must be called on to maintain blood sugar levels.
PCOS is also characterized by higher insulin levels. This prevents ovulation, causing infertility and female hormone imbalance.
When insulin resistance persists, type II diabetes, where the body is no longer able to keep blood sugar in a safe range, develops.
Type II diabetes is characterized by chronically high blood sugar—which poses a danger to small blood vessels, and is a potent inflammatory condition, increasing the risk of heart disease—and elevated insulin.
It affects almost 10% of the adult population and is the 7th leading underlying cause of death in North America, costing 350 billion dollars a year to manage in the United States alone.
Insulin-related weight gain can affect female hormones, as fat cells make estrogen in the body, leading to estrogen dominance.
Insulin also interacts with a hormone called leptin, which is created by fat cells in response to calorie intake. When body fat levels get too high, cells can become leptin resistant. The body no longer senses dietary calorie intake, leading to increased hunger. This exacerbates the problem of weight gain and insulin resistance.
Testing for Insulin Resistance
When I meet a patient who is presenting with stubborn weight gain, estrogen dominance and stress, I assess their blood for insulin resistance by looking at blood levels of fasting insulin and fasting glucose.
With these two values a calculation that measures insulin resistance, called the HOMA-IR, can be performed. This can give us a baseline measure of how well the body is compensating to control blood glucose.
I also run HbA1c, which looks at glucose levels over 3 months. I will often run a blood cholesterol panel, and inflammatory markers, such as CRP.
Insulin resistance often puts all of our hormones on a rollercoaster, which becomes very difficult to get off of unless we prioritize the diet and lifestyle interventions that address blood sugar control.
Assessing Hormones
When presented with a patient suffering from a complicated symptom pattern, I begin by taking a thorough health history in which we investigate:
Energy levels,
Sleep quantity and quality,
Mood and mental health history,
Period health history,
Family history,
Dietary intake and exercise,
Health risk factors like smoking, alcohol use, and past health history.
Depending on how clear the patient’s symptom picture presents, we may opt to make some changes before testing, to gauge their body’s response to an increase in nutrient intake.
Then, if necessary, I will order a comprehensive blood work.
Blood testing might include a thyroid hormone panel, and an in-depth look at female hormones, fasting insulin and fasting blood glucose, and other markers that help us assess health, such as cholesterol and inflammatory markers, or nutrient levels.
Patients requiring a more comprehensive view of their cycles may opt for month-long salivary testing. Others may opt for a dried urine test that looks at hormonal breakdown in the body.
A Sample Case
Jenny (name changed for privacy) came to me feeling fatigued and anxious.
She had suffered from anxiety periodically as a teen, but now at age 46 she was experiencing bimonthly panic attacks that seemed to occur cyclically; the panic would come around ovulation and premenstrually.
It was hard to tell, however, because Jenny also claimed that her periods were “all over the place”. One month they were heavy and painful, causing her to take time off work, crouched on the bathroom floor in agony. Other months she barely noticed them, experiencing some light spotting, if anything at all.
Very troubling to her was her major mood volatility, which she described like a “switch” that would suddenly flip on or off, causing her to breakdown at work or pick fights with her family.
Then, almost as suddenly, the cloud would lift and she would be her cheerful, friendly, loving self again.
It was maddening, both to her and those living with her during these darks times, she said.
She also noticed disrupted sleep and weight gain around the abdomen, which seemed to ignore her intense workouts and strict dietary regime.
Jenny was highly accomplished at her high-pressure job and commented that she thrived on being busy and achievement oriented.
I tested Jenny’s blood estradiol, estrone, progesterone, LH, and FSH levels one week before her next expected period, had her fill out a weekly diet diary, and gave her some recommendations about sleep and supplement intake.
Jenny’s blood revealed elevated FSH, indicative of impending menopause (FSH encourages the ovaries to ovulate, as TSH encourages the thyroid gland to make thyroid hormone). She also had low estradiol, and low progesterone, but elevated levels of estrone, the more problematic of the estrogens.
According to her labs and history, Jenny was experiencing estrogen dominance and perimenopause. Many of her symptoms were stemming from elevated estrone, low progesterone and a disrupted HPA axis.
Together, we worked on her diet to provide her body with the nutrients needed to make hormones and to support her brain, mood and adrenal glands.
We used herbs and dietary nutrients to promote liver estrogen clearance and to support Jenny’s adrenal glands.
We addressed the stress in her life, encouraged relaxation, and made sure her body was supported in its ability to make and respond to cortisol.
After a few months, Jenny reported a reduction in hot flashes, better sleep and feeling calmer. She had a reduction in her waist line and better energy and mood.
Our hormones, when imbalanced, can cause vicious cycles in the body that trap us in a state of worsening imbalance.
Through correctly assessing these common hormonal patterns through a health history and appropriate testing, and then making diet, lifestyle and supplement suggestions addressed at stopping these cycles, naturopathic doctors can address underlying hormonal issues that might be causing these complex and troublesome patterns of hormone disruption.
