The 3-Minute Responsive Breathing Space

This is one of my favourite exercises from Mindfulness Based Cognitive Therapy, or MBCT, and just one exercise in an 8-week course directed at those who suffer from depression and anxiety.

This exercise helps us practice staying with difficult thoughts, emotions, and body sensations, teaching us to turn towards difficulty, rather than turning away.

It is better to do this exercise when difficulty is already present.

Try to use a 10 lb weight, not a 100 lb weight. However, in many situations, we don’t get to choose. If the practice is particularly intense, you can perhaps focus on the breath, or open your eyes and let go of the practice.

Note: this video is to support a mindfulness practice and to use in conjunction with help from a licensed mental health professional.

A Letter to Myself at 32

A Letter to Myself at 32

I often encourage my patients to write a letter to themselves on their birthdays for the following year using a website called FutureMe.org, where you can post-date emails to yourself to any date in the future. This exercise is great to do on any day, really. Tomorrow is my birthday. I’ll be 32. Here is my letter. 

This is it.

This is your life.

As Cheryl Strayed wrote, “The f— is your life. Answer it.”

There are some things that you thought were temporary, mere stepping stones on your way to someplace better, that you now realize are familiar friends, ever present in their essence, but varying in their specific details.

For instance:

1) You will ride buses.

You will never escape the bus. For a while taking the bus was seen as a temporary stop on your way to something else (a car?). You took the bus as a pre-teen, excited to finally be allowed to venture to parts of town alone. As a student, you took the bus to the mall, laughing at the ridiculousness of Kingston, Ontario, once you’d left the protective bubble of the student community, completely inappropriately, yet affectionately (and ignorantly) called The Ghetto.

You will visit other ghettos, also by bus, that are far more deserving of their names. However these ghettos will instead have hopeful names such as El Paraiso, or La Preserverancia. Those who live there will persevere. So will you.

Buses will take you over the mountains of Guatemala, to visit student clients in Bogota, Columbia. To desirable areas of Cartagena. You’ll ride them through India. They will carry you through Asia, bringing you to trains and airports.

You’ll ride buses as a doctor. You’ll ride the bus to your clinic every day.

Sometimes, on long busy days in Toronto, it’ll seem like you’ll spend all day trapped in a bus.

The bus is not a temporary reality of your life. The bus is one of the “f—s” of your life. You’ll learn to answer it. You’ll learn to stop dissociating from the experience of “getting somewhere” and realize you are always somewhere. Life is happening right here, and sometimes “right here” is on the seat of a bus. Eventually you start to open up, to live there. You start to live in the understanding that the getting somewhere is just as important as (maybe more than) arriving.

We breathe to fill our empty lungs. Almost immediately after they’re full, the desire to empty them overwhelms. Similarly, you board a bus to get somewhere, while you’re on the bus, you start to understand.

You’re already here.

Maybe you’ll graduate some day, to a car.

But sooner or later, you’ll board a bus.

And ride it again.

2). You’ll experience negative emotion, no matter who you are or what your life circumstance.

Rejection, worthlessness, sadness, and heart break, are constant friends. Sometimes they’ll go on vacation. They’ll always visit again.

You will never reach the shores of certainty. You will never be “done”. You may take consolation in momentary pauses, where you note your confidence has found a rock to rest its head against. But you’ll grow bored of your rock (it is just a rock, lifeless, after all). You’ll then dive back into the deep waters of doubt, risk despair, and swim again.

Happiness isn’t a final destination. Instead, it’s a roadside Starbucks: a place to refuel, and maybe passing through is an encouragement you’re headed in the right direction.

3). The people in your life are like wisps of smoke.

They will come and go. Some of them will simply whiff towards you, visiting momentarily. Their names you’ll hardly remember. You’ll share ice cream and one deep, healing conversation about love that you’ll remember for years to come. You’ll reflect on this person’s words whenever you consider loving someone again.

You’ll remember the ice cream, the warm sea breeze, the thirst that came afterwards, the laughter. But it will be hard to remember his name… David? Daniel? You won’t keep in touch, but you’ll have been touched.

There will be others who come to seek your help. You might help them. You might not. They might come back regardless, or never return. Many times it will have nothing to do with the quality of your help. Or you.

Sometimes the smoke from the flame will thicken as you breathe oxygen into it. People will come closer, you’ll draw them in, inhale them.

Sometimes you’ll cough and blow others away.

You’ll wonder if that was a wise choice. You’ll think that it probably was.

Does a flame lament the ever-changing smoke it emits? Does the surrounding air try to grasp it? Do either personalize the dynamic undulations of smoke, that arise from the candle, dance in the fading light and dissipate?

Flames don’t own their smoke. They don’t seem to believe that the smoke blows away from them repelled by some inherent deficiency in them. Flames seem to accept the fact that smoke rises and disappears, doing as it’s always done.

4). Not everything is about you.

There will be times when failure lands in your lap. You’ll wonder if it’s because there is some nascent problem with you, that only others can see. These failures will tempt you to go searching for it.

You’ll find these faults. These deficiencies. In yourself, in others, in life itself.

You’ll wonder if it explains your failures. You’ll wonder why the failures had to happen to you.

You think that people can smell something on you, that your nose is no longer able to detect, like overwhelming perfume that your senses have grown used to, but that assaults the senses of others around you.

Failure and rejection, cause your heart to ache. Your heart aches, as all hearts do. The hearts of the virtuous, famous, heroic, and rich ache just as hard. The hearts of those who have committed evil deeds also split apart. (The only hearts that don’t may be the truly broken, the irredeemable. And those people are rare.)

You will experience joys. Your heart will mend and break, a thousands times.

And it has nothing to do with you.

5). Success is not a final destination.

There are no destinations. You will ride buses, you will feel happy, you will feel joy. You will try. You will succeed.

And you won’t.

You’ll pick up the pieces of your broken heart. You will mend them. You will flag down the next bus.

You will board it.

You will grasp—you can’t help it. Grasping will only push the wisps of smoke away, causing it to disappear in your hands. This will frustate you, but you’ll keep doing it.

Over and over.

And failing.

You’ll grasp some more and come up empty, thinking that it is because something is wrong with me. There is lots wrong with you.

There is lots right with you.

Most things have nothing to do with you. (That might be just as painful to accept

But healing as well.)

No one said healing didn’t hurt. Sometimes it f—ing hurts! But, as Cheryl Strayed wrote, “the f— is your life”.

And answering it is your life’s process.

Preventive Medicine: 9 Root Causes of Disease

Preventive Medicine: 9 Root Causes of Disease

I often get emails like this, “Dear Doctor, please tell me your favourite natural cure for anxiety”, to which I often reply:

Dear, Anxiety,

Imagine you are a gardener, tending to your garden. You are a skilled gardener: you tend lovingly to your plants every day and you care deeply for their welfare.

You are the perfect gardener in every way, except for one: for some reason you don’t know anything about soil.

No one has ever taught you about the damp, dark soot that envelopes the roots of your beloved plants, kindly offering to them its protection, water, and nutrients.

You are a gardener, but are innocently oblivious to the fact that soil must be nurtured by millions of microbes, and that nutrients in the soil must be replenished. You have no idea that the other plants sharing the soil with your garden form a complex network of give and take, depositing nutrients into it, while greedily sucking others away.

Now, as this soil-ignorant gardener, imagine your surprise when, despite your care and attention, the plants in your garden wither and die, bearing no flowers or fruit.

Imagine your frustration when your efforts to prop up tired stems fail. You apply water and fertilizer to buds, leaves and stems. You stand by, powerless, as your garden dies.

Notice the weeds taking over your garden, which you lop off at their stems, unaware that their roots reside deep inside the earth.

When the weeds pop up again and again, you slash at them, burn them, and you curse the skies.

“Why me?”

Why you, indeed.

You are unaware of root gardening, soil gardening, just as many of us are unaware of root medicine—soil medicine.

You see, Anxiety, there are many natural remedies that can help.

However, tossing natural pills at twitching nerves, imbalanced blood sugar, unregulated stress responses, and various nutrient deficiencies, might be as naive a practice as spray painting your roses while they wilt in sandy earth, beneath their red paint.

It might be akin to prescribing anxiety medication or a shot of vodka to calm your trembling mind; you might feel better for a time, propped up with good intentions, before collapsing in the dry soil encasing you.

With no one to tend to your roots you eventually crumple, anxiety still rampant.

“Why me?” You curse the skies.

Rather than asking, “Why me?” it might help to simply start asking, “Why?”

While it is important to understand the “What” of your condition—What disease is present? What is the best natural cure for anxiety?—naturopathic doctors are far more interested in the “Why”.

As Dr. Mark Hyman, functional medical doctor, asks:

Why are your symptoms occurring?

Why now?

And why in this way?

Naturopathic doctors prescribe natural remedies for conditions such as anxiety, it’s true. However, naturopathic medicine is a medicine that first tends to the soil.

Naturopathic doctors first look for and addresses the roots of symptoms, working with the relationships that exist between you and your body, your food, the people in your life, your society, your environment—your soil.

Healing involves taking a complete inventory of all the factors in your life that influence your mental, physical, and emotional wellness. It requires looking at the air, water, sunlight, nutrients, stressors, hormones, chemicals, microbes, thoughts and emotions that our cells bathe in each day.

Healing means looking closely at the soil that surrounds us. It requires asking, What are the roots that this condition stems from? And, What soil buries these roots? Does it nourish me?

Do I nourish it?

The causes of disease can be interconnected and complex. Very often, however, there are common root networks from which many modern-day chronic health conditions arise.

Starving Gut Bacteria.

It was Hippocrates, the father of medicine, who first proclaimed that “All disease begins in the gut.”

Our digestive systems are long, hollow tubes that extend from mouth to anus, and serve as our body’s connection to the outside world. What enters our digestive system does not fully become the body until the cells that line that digestive tract deem these nutrients worthy of entering.

Along their 9 metre-long, 50-hour journey, these nutrients are processed by digestive enzymes, broken down by trillions of beneficial bacteria, and sorted out by the immune cells that guard entrance to our vulnerable bodies.

Our immune cells make the judgement call between what sustains us, and what has that potential to kill us. For this reason, about 70% of our immune system is located along our digestive tract.

Our gut bacteria, containing an estimated 30 trillion cells, outnumber the cells in our body 3 to 1. Science has only just begun to write the love story between these tiny cells and our bodies. These bacteria are responsible for aiding in the digestion of our food, producing essential nutrients, such as B vitamins and fat-soluble vitamins, and keeping our intestines healthy.

However, this love story can turn tragic when these little romantics are not properly fed or nurtured, or when antagonists enter the story in the form of pathogenic bacteria or yeast.

Our microbiome may impact our health in various ways.

Studies are emerging showing that obese people have different gut profiles than those who are normal weight. Our gut bacteria have a role in producing the hormones that regulate hunger, mood, stress, circadian rhythms, metabolism, and inflammation. They regulate our immune system, playing a role in soothing autoimmune conditions, and improving our ability to fight off infections and cancer.

Psychological and physical stress, inflammation, medication use, and a diet consisting of processed food, can all conspire to negatively affect the health of our gut. This can lead to a plethora of diseases: mood disorders, psychiatric illness, insulin resistance, cardiovascular disease, chronic pain and inflammation, obesity, hormonal issues, such as endometriosis, autoimmune disease, and, of course, chronic digestive concerns such as IBS, among others.

As Hippocrates long knew, one doesn’t have to dig for long to uncover an unhappy gut microbiome as one of the primary roots of disease.

Our gut has the power to nurture us, to provide us with the fuel that keeps our mood bright and our energy high. However, if we fail it, out gut also has the power to plague our cells with chronic inflammation and disease.

To be fully healthy, we must tend to our gut like a careful gardener tends to her soil.

This involves eating a diet rich in fermented foods, like kefir, and dietary fibre, like leeks, Jerusalem artichokes, and black beans. It also means, consuming flavonoid-rich foods like green tea, and cocoa, and consuming a colourful tapestry of various fruits and vegetables.

Healing our gut requires avoiding foods it doesn’t like. These may include foods that feed pathogenic bacteria, mount an immune response, kill our good bacteria, trigger inflammation, or simply those processed foods that fail to nurture us.

To heal ourselves, first we must feed out gut.

Confused Circadian Rhythms.

For hundreds of thousands of years, all of humanity rose, hunted, ate, fasted, and slept according to the sun’s rhythms.  

To align us with nature, our bodies contain internal clocks, a central one located in brain, the suprachiasmatic nucleus, which is susceptible to light from the sun, and peripheral clocks located in the liver and pancreas, which respond to our eating patterns.

Our gut bacteria also respond to and influence our body’s clocks. 

However, the invention of electricity, night shifts, and 24-hour convenience stores, means that our bodies can no longer rely on the outside world to guide our waking and sleeping patterns. This can confuse our circadian rhythms, leading to digestive issues, insomnia, daytime fatigue, mood disorders, and problems with metabolism, appetite, and blood-sugar regulation.

Dr. Satchin Panda, PhD, a researcher at the Salk Institute in California, found that mice who ate a poor diet experienced altered circadian rhythms. However, he found that when these mice were fed the same diet in accordance with their natural rhythms, they weighed less, had lower incidences of diabetes and cardiovascular disease, had better cognitive health, and lived longer.

These findings indicate that perhaps it is not what we eat but when that may impact our health.

Perhaps it is that an unnatural diet disconnects us from nature, or that this disconnection tempts us to choose non-nutritive foods, but the research by Dr. Panda and his team reveals the importance of aligning our daily routines with our bodies’ natural rhythms in order to experience optimal health.

According to Dr. Panda’s findings, this involves eating during an 8 to 12-hour window, perhaps having breakfast at 7am and finishing dinner early, or simply avoiding nighttime snacking.

For many of us, this may involve making the effort to keep our sleep schedules consistent, even on weekends.

For most of us, it involves avoiding exposure to electronics (which emit circadian-confusing blue light) after the sun goes down, and exposing our eyes to natural sunlight as soon after waking as possible.

Nature Deficit Disorder.

Nature Deficit Disorder is a phrase, coined by Richard Louv, in the 2005 book, Last Child in the Woods.

According to Louv, a variety of childhood problems, especially mental health diagnoses like ADHD, are a direct result of our society’s tendency to increasingly alienate children from nature.

With most of humanity living in cities, nature has become a place we visit, rather than what immerses us. However much modernization might remove us from nature, our bodies, as well as the food, air, water, sunlight, and natural settings they require to thrive, are products of nature, and cannot be separated from it.

A Japanese practice called Shinrin-Yoku, or “Forest Bathing”, developed in the 1980’s to attempt to reconnect modern people with the healing benefits of spending time in a natural setting. There is an immediate reduction in stress hormones, blood pressure, and heart rate when people immerse themselves in natural environments, such as a forest. 

Whether we like it or not, our roots need soil. It is possible that the components of this soil are too complex to manufacture. When we try to live without soil, essential elements that nourish us, and the various relationship between these elements are left out.

When we remove ourselves from nature, or ignore it fully, we become like gardeners oblivious to the deep dependency their plants have on the soil that enshrouds them.  

Connecting with nature by spending time outside, retraining our circadian rhythms, connecting with our food sources, and consuming natural, whole foods, may be essential for balancing our minds, emotions, and physical bodies.

A Lack of Key Building Blocks.

Our bodies are like complex machines that need a variety of macro and micronutrients, which provide us with the fuel, building blocks, vitamins and minerals that we need to function.

As I child, I would play with Lego, putting together complex structures according to the blueprints in the box. When I discovered that a piece was missing, I would fret. It meant that my masterpiece would no longer look right, or work. If I was lucky, I might find a similar piece to replace it, but it wouldn’t be the same.

After looking long and hard for it, sometimes the missing piece would turn up. I’d locate it under the carpet, my brother’s bottom, or lodged in a dark corner of the box. Often our bodies don’t get that lucky.

Nutrients like vitamin B12, perhaps, or a specific essential amino acid, or a mineral like magnesium, help our body perform essential steps in its various biochemical pathways.

These pathways follow our innate blueprint for health. They dictate how we eat, sleep, breathe, and create and use energy. They control how our bones and hair grow. They control our mood and hormones. They form our immune systems. These pathways run us.

Our bodies carry out the complicated instructions in our DNA to will us into existence using the ingredients supplied from food. If our bodies are missing one or several of these ingredients—a vitamin or mineral—an important bodily task simply won’t get done.

Dr. Bruce Ames, PhD, theorized that when nutrient levels are suboptimal, the body triages what it has to cove tasks essential to our immediate survival, while compromising other jobs that are important, but less dire.

For example, a body may have enough vitamin C to repair wounds or keep the teeth in our mouths—warding off obvious signs of scurvy, a disease that results from severe vitamin C deficiency. However, it may not have enough to protect us from the free radicals generated in and outside of our bodies. This deficiency may eventually lead to chronic inflammation, and even cancer, years later.

According to Dr. Ames’ Triage Theory, mild to moderate nutrient deficiencies may manifest later in life, as diseases that arise from the deprivation of the building blocks needed to thrive.

In North America, despite an overconsumption of calories, nutrient deficiencies are surprisingly common.

25-50% of people don’t get enough iron, which is important for the transport of oxygen, the synthesis of neurotransmitters, and for proper thyroid function.

One third of the world’s population is deficient in iodine, which affects thyroid health and fertility.

Up to 82% of North Americans are vitamin D deficient. Vitamin D regulates the expression of over 1000 genes in the body, including those involved in mood regulation, bone health, immunity, and cancer prevention.

Vitamin B12 is commonly deficient in the elderly, vegans and vegetarians. It is important for lowering inflammation, creating mood-regulating neurotransmitters, and supporting nervous system health. Deficiency in vitamin B12 can result in fatigue. Severe deficiency can lead to irreversible nerve damage, dementia, and even seizures.

Magnesium is an essential mineral involved in over 300 chemical reactions, including mood and hormone pathways. Over 40% of North Americans do not consume enough magnesium, which is found in leafy green vegetables.

Our bodies have requirements for fats, which make up our brain mass and the backbone of our sex hormones, and protein, which makes up our enzymes, neurotransmitters and the structure of our body: bones, skin, hair, nails, and connective tissue.

Our gut microbiota require fibre.

Our cells need antioxidants to help protect us from the free radical damage from our own cells’ metabolism and our exposure to environmental toxins.

We certainly are what we eat, which means we can be magnificent structures with every piece in place, thriving with abundance and energy.

Despite reasonably good intentions, we can also suffer from nutrient scarcity, forced to triage essential nutrients to keep us from keeling over, while our immune health, mood, and overall vitality slowly erode.

A Body on Fire: Chronic Inflammation.

When we injure ourselves—banging a knee against the sharp edge of the coffee table, or slashing a thumb with a paring knife—our immune systems rally to the scene.

Our immune cells protect us against invaders that might take advantage of the broken skin to infect us. They mount an inflammatory response, with symptoms of pain, heat, redness, and swelling, in order to heal us. They recruit proteins to the scene to stop blood loss; they seal our skin back up, leaving behind only a small white scar—a clumsiness souvenir.

Our inflammatory response is truly amazing.

One the danger has been dealt with, the immune response is trained to turn off. However, when exposed to a stressor, bacteria, or toxin, for prolonged periods, our immune system may have trouble quieting. Chronic issues can contribute to chronic inflammation.

Scientists argue that an inflammatory response gone rogue may be the source of most chronic diseases, from heart disease, cancer, and diabetes, to schizophrenia and major depressive disorder. 

The gut is often the source of chronic inflammation as it hosts about 70% of the immune system. When we eat something that our immune system doesn’t like, an inflammatory response is triggered. This can cause digestive issues such as inflammatory bowel disease, celiac disease, and the more common irritable bowel syndrome. It can also lead to more widespread issues like chronic pain, arthritis, migraines, and even mood disorders like Bipolar.

Ensuring optimal gut health through nurturing the gut microbiome, and eating a clean diet free of food sensitivities, is essential for keeping the body’s levels of inflammation low.

Constant Fighting and Fleeing.

Like inflammation, our stress response is essential to our survival.

When facing a predatory animal, our body is flooded with stress hormones that aim to remove us from the danger: either through fighting, fleeing, or freezing. Our stress response is affectionately called our “Fight or Flight” response.

However, like inflammation, problems arise when our stress response refuses to turn off. Traffic, exams, fights with in-laws, and other modern-day struggles, can be constant predators that keep us in a chronically stressed-out state.

Chronic stress has major implications for our health: it can affect the gut, damage our microbiome, alter our circadian rhythms, mess with mood and hormones, and contribute to chronic inflammation. Stress gets in the way of our ability to care for ourselves: it isolates us, encourages us to consume unhealthy foods, and buffer our emotions through food, alcohol, work, and drugs.

We also know that stress has a role in the development of virtually every disease. Like chronic inflammation, it has been found to contribute to chronic anxiety, depression, digestive concerns, weight gain, headaches, heart disease, insomnia, chronic pain, and problems with concentration and memory, among others.  

Discomfort with Discomfort.

To assess its impact on health, it helps to determine between two key types of stress: distress, the chronic wear and tear of traffic, disease, and deadlines, and eustress.

Eustress is beneficial stress—the short-lived discomfort of intense exercise, the euphoric agony of emotional vulnerability, or the bitter nutrients of green vegetables—that makes the body more resilient to hardship.

Whenever I feel discomfort, I try to remember the ducks.

Several years ago, on a particularly frigid winter day, I was walking my dog. Bundled against the cold wind, we strolled along the semi-frozen lake, past tree branches beautifully preserved in glass cases of ice. Icebergs floated on the lake. So did a group of ducks, bobbing peacefully in the icy waters.

With nothing to protect their thin flippers from the sub-zero temperatures, they couldn’t have felt comfortable. There couldn’t have been even a part of them that felt warm, cozy, or fed.

There was no fire for them to retreat to, no dinner waiting for them at home, no slippers to stuff frozen, wet flippers into. This was it. The ducks were here, outside with us, withstanding the temperatures of the icy lake. A part of them must have been suffering. And yet, they were surviving.

Far from surviving, the ducks looked down-right content.

I think of the ducks and I think of the resilience of nature.

We humans are resilient too. Like the ducks, our bodies have survived temperature extremes. Our ancestors withstood famine, intense heat, biting cold, terrible injury, and the constant threat of attack and infection, for millenia. You were born a link on an unbroken chain of survivors, extending 10,000 generations long.

Our bodies have been honed, over these hundreds of thousands of years, to survive, even thrive, during the horrendous conditions that plagued most of our evolutionary history.

Investigations into the human genome have revealed genes that get turned on in periods of eustress: bursts of extreme heat or cold, fasting, and high-intensity exercise. When our body encounters one of these stressors, it activates a hormetic response to overcome the stress. Often the response is greater than what is needed to neutralize the threat, resulting in a net benefit for our bodies.

These protective genes create new brain cells, boost mitochrondria function, lower inflammation, clear out damaged cells, boost the creation of stem cells, repair DNA, and create powerful antioxidants. Our bodies are flooded with hormones that increase our sense of well-being.

It’s like the old adage, “What doesn’t kill you makes you stronger.”

Our bodies were made for discomfort. In fact, we have entire genetic pathways waiting to kick in and heal us as soon as they experience hardship.

There are a growing number of studies on the healing power of small troubles. Fasting may have a role in treating autoimmune diseases, decreasing the signs of aging, and as an adjunct therapy for cancer; sauna therapy boosts detoxification and may prevent dementia; cryotherapy, or exposure to extreme cold, has the potential to heal arthritis and autoimmunity; and High Intensity Interval Training has been shown to boost cardiovascular health more than moderate-intensity exercise.

Plants may benefit us through flavonoids, which, rather than serving as nutrients, act as small toxins that boost these hormetic pathways, encouraging the body to make loads of its own, powerful antioxidants to combat these tiny toxins.

Mindfully embracing discomfort—the bitter taste of plants, the chilly night air, the deep growling hunger that occurs between meals—may be essential for letting our bodies express their full healing potential.

Not Minding Our Minds.

Our ability to withstand powerful emotions may have healing benefits.

Many of us avoid painful feelings, allowing them to fester within us. We buffer them with excess food, or drugs, leading to addictions. Mindfulness can help us learn to be with the discomfort of the emotions, thoughts and physical sensations that arise in the body as inevitable side effects of being alive.

Research has shown that mindfulness can help decrease rumination, and prevent depressive relapse. It also helps lower perceived stress. How we perceive the stressors in our lives can lower the damaging effects they have on us. Research shows that those who view their life stressors as challenges to overcome have lower stress hormone activation, and experience greater life satisfaction.

According to Cognitive Behaviour Therapy (CBT), our thoughts create our emotions. Becoming more aware of our thoughts, through CBT or mindfulness, allows us to identify which thoughts may be limiting us or exacerbating our reactions to stressful situations.

When we learn to observe our thoughts, we create some distance from them. We become less likely to see the dismal thoughts in our minds as absolute truths.

Practicing mindful meditation, CBT, or cultivating positive thoughts, such as engaging in a daily gratitude practice, may improve our resilience to chronic stress.

Inattention.

According to Stephen Cope, yoga teacher and author of The Great Work of Your Life, “You love what you know deeply. Get to know yourself deeply”. We get to know things deeply by paying attention to them.

Georgia O’Keefe’s admiration for flowers, or Monet’s adoration of landscapes, is apparent to anyone who sees their work. In order to commit images to canvas, the artists gets to know their subject matter deeply. Their art celebrates what they took the time to pay attention to, and eventually came to love. 

As a naturopathic doctor, I believe that healing begins with attention. When we become aware of our bodies, we begin to know them deeply. Awareness allows us to respond to symptoms lovingly, the way a mother learns to skillfully attend to her baby’s distinct cries.

When I first meet a new patient, the first thing I have them do is start to pay attention.

We become curious about their symptoms, their food intake, their sleep patterns, their habits and routines, the physical sensations of their emotions, the thoughts that run through their heads.

Through paying attention, with non-judgmental curiosity, my patients start to understand their bodies in new ways. They learn how certain foods feel in their bodies, how certain sleep habits affect their energy levels the next day, and how specific thoughts contribute to their feelings.

Once we begin to open up this dialogue with our bodies, it becomes impossible not to answer them with love. It becomes hard not to eat, sleep, and move in ways that convey self-respect.

A gardener who pays deep attention cannot ignore the obvious—her plants have roots, embedded in soil. The gardener quickly learns, through careful observation, that the health of this soil is vital to the health of her plants.

And so, back to the original question, “What is your favourite natural cure for anxiety?”

My favourite remedy isn’t a bottle of pills we reach for, it’s a question we reach for from within:

“What do I need to heal?”

After asking the question, we wait.

We wait for the answer to emerge from some primal place within, just as a gardener waits for new buds to rise out of the mysterious depths of the dark, nutritious soil.

 

I Am Not My Thoughts: A Lesson in Meta-Awareness

I Am Not My Thoughts: A Lesson in Meta-Awareness

Mindfulness philosophy tells us that our thoughts and emotions are simply phenomena that arise in our bodies and minds: they are not us.

Those of us who suffer from depression and anxiety tend to enter cycles of over-thinking. The mind wanders and engages in self-focused rumination that feeds negative emotions, worsening mood.

While ruminating, we think about the causes and consequences of our depression; we reflect on mistakes we’ve made in the past, we dwell on our perceived personal faults, and we speculate about how we’ll fare negatively in the future.

This kind of rumination becomes a scratch-itch cycle that causes us to feel worse.

However, learning to engage the contents of self-focussed mind-wandering as a non-judgmental observer may be the key to stopping this cycle.

Those who are able to step back and become aware of awareness or think about thoughts, as opposed to getting lost in them, tend to have better control over their thought processes as a whole, and thus their emotions. Mindfulness involves taking a non-judgmental, curious stance about the contents of the mind, as an impartial witness.

Studies show that mindfulness, or taking this non-judgmental, curious stance, can change brain areas associated with rumination, and emotional regulation.

This fall I took a course to obtain a facilitator certificate for Mindfulness-Based Cognitive Therapy (MBCT), an evidence-based 8-week program that aims to treat depression and anxiety through imparting mindfulness skills. Because of the growing evidence base on the benefits of mindfulness for stress and mental health, the facilitator program attracts many medical professionals.

One of the course participants, a psychiatrist, didn’t like me. I noticed her frowning in my direction every time I spoke. She deliberately avoided and ignored me, talking to everyone else in the course but me.

As the only naturopathic doctor in the group, the other participants showed some curiosity towards my field. When I answered their questions, the psychiatrist’s face seemed to twist into a subtle expression of disgust and disapproval.

She thought I was a quack, a hack; I didn’t have enough training. She assumed I wasn’t qualified enough to provide care to those who suffer from mental health concerns. I could feel her judging energy from across the room every time I lifted my hand to answer a question, or make a comment. Her deploring gaze scrutinized my every move.

I was a naturopathic doctor and she, a psychiatrist. We had emerged from different worlds, philosophies, and backgrounds—we were from incompatible ends of the mental health professional spectrum. Of course she didn’t approve of me: it was only to be expected.

We were spending all day meditating, and this is the story my mind had decided to write.

At the end of day 3 of the course, with days of evidence selectively compiled to support my story about this disapproving psychiatrist’s opinion of me, I left class to head for the bus stop. Waiting for the same bus was no one other than my nemesis.

Great, I thought. I smiled at her, stiffly.

She smiled at me.

“Talia, right?” She asked.

I nodded: yes, Talia.

“You’re the naturopath, right?” She inquired, brows kneaded together in a frown.

I nodded again, bracing myself. Are we really going to do this here? 

But then, time-space cracked and split open, revealing an alternate universe to the one in my own head. Her face melted into a warm grin, “Oh, I love naturopaths!” She exclaimed warmly.

She went on to describe her wonderful encounters with the members of my profession who had attended to the various personal health concerns she’d faced.

“I’m so interested in holistic health for managing mental health concerns,” She said, before leaning in a bit, conspiratorially, and adding in hushed tones, “You know, psychiatry doesn’t work.”

I stood there, dumbfounded.

Her particular opinions about psychiatry aside: not only was the entire story I’d written and held onto for the past few days wrong, it was way wrong. I had fabricated an entire story in my head, corroborated by what I had been convinced was real evidence. The realization of how avidly I’d bought into this story, as if it were simple fact, was earth-shattering.

My story, had just been that: a story, conjured up by thoughts. These thoughts bore no relationship to reality at all, no matter how convincingly they had presented themselves.

It rare to have the opportunity to experience our mental constructs and biases topple so dramatically. The mind has a tendency to rationalize away any evidence contrary to our beliefs—”Well, I only passed because I got lucky”, or “The test was easy”, or “She said she liked my hair—liar”.

Very few of us entertain the idea that our thoughts and emotions don’t represent our ultimate reality.

According to Mindfulness Theory it helps to think of our minds as movie screens and our thoughts, emotions, and body sensations as contents of the movie. We can watch the action, identify with the characters, and follow the plot with invested interest. The movie can inspire thoughts and emotions within us, both positive and negative. The movie can grip us; we might lose ourselves in the drama, forgetting that we are mere witnesses to it.

It can help to remember that we are not the movie. Sometimes it’s helpful to remember that we’re not even acting in the movie.

No matter how deeply the film may move us, we can always take the stance of movie-going witness. We can take various perspectives in relation to the drama on screen. We can immerse ourselves in the drama, losing our sense of self completely. We can remember that we are audience members, enjoying a film. We can ignore the movie altogether and laugh to a friend sitting beside us. We can be aware of the contents of the movie theatre, the people sitting around and behind us, or the sticky floor under our feet. We can even leave the theatre, which we will certainly do once the credits roll—it’s just a movie after all, a distraction from the reality of our lives.

In the way that we approach the contents on a movie screen, we can take various stances towards the contents of our minds.

Meta-awareness is the act of remembering that we are movie watchers—the act of becoming aware of awareness itself. When we practice meta-awareness, we take a non-judgmental view of our thoughts and emotions, watching them arise in our bodies and minds like the drama in a movie arises onscreen.

We can easily identify with the tens of thousands of thoughts that appear on the movie screens of our lives. We may be convinced that we’re unloveable, that we’re failures, or that life is hopeless, simply because these particular thoughts have appeared in our mind’s screen. We can also identify with positive thoughts, such as the idea that we’re excellent swimmers, or good fathers.

Our thoughts may reflect reality—we may have the thought that if we step into a pool of water our feel will get wet—but simply having a thought does not create reality itself.

While taking the bus that day, I realized that I had unwittingly cast my psychiatric colleague as the guest-star of People Who Are Judging Me, an episode in Unloveable: The Series, which is a piece of entertaining fiction that my mind has written, directed, produced, and cast me as the lead in. I often forget that I’m simply an audience member watching the movie of my mind’s creation—this movie is not necessarily the truth about my life.

Research has identified a network in the brain called the Default Mode Network (DMN), that connects the lower brain areas, like the amygdala and hippocampus, with higher brain centres in the prefrontal cortex. The DMN is active when our minds are wandering and is particularly active when those with depression are ruminating and engaging in narrative self-referencing: or attributing one’s self as the cause of (negative) events in one’s life—for example, interpreting an expression on someone’s face to be a look of disgust and assuming it’s because they disapprove of your profession.

Meditation, particularly practicing meta-awareness, can produce shifts in the DMN that decrease rumination. Practicing meta-awareness allows us to rescue our identities from the tyranny of thought. We watch and detach from thought, watching them rise and fall in the mind without clinging to them. By becoming aware of our thoughts and emotions and taking a curious attitude towards them, we can break the cycle of rumination, thereby supporting our mental health. Observing thoughts, rather than becoming lost in their drama, allows us to feel and behave independently of them.

For example, simply having the thought, “I’ll always be alone,” doesn’t have to produce a negative emotion, if I recognize it as just a thought.

We might reframe the thought “She hates me” to be: “I just had a thought that this person hates me. It’s just a thought that I have no way of knowing for certain is true. I will smile warmly at her anyways. I might be completely wrong.”

Or, we can do nothing, waiting until the thought “She hates me” passes through the screen of our minds.

We can turn off this particular movie, and put on a new one. After all, we can’t stop the flow of thoughts: there will always be others to take their place.

Lesson learned: I am not my thoughts.

And: some psychiatrists are way more hippy than I am.

13 Ways to Self-Care

13 Ways to Self-Care

Humour me for a moment. Take a moment to imagine your “happy place”—the place you feel most at home. Where are you? What are you doing? Who is there with you?

What are the sights, sounds, smells, tastes, and sensations that fill the air and tickle your skin? What are the internal bodily sensations you notice when you find yourself here, in this place? What emotions do you feel?

I’ll venture some guesses: you feel calm, at peace, safe, energized, connected, and integrated. If you turn your attention to your breathing you probably notice that it’s slow, deep, restorative. That head cloud of frenzied thoughts and worries that you tend to spend your time in might have cleared. Your sense of “self” has probably moved out of your head and into your body.

Maybe, through doing this short exercise, you’ve come home to yourself, even just a little.

1) Understand what “self-care” means.

A friend recently shared a Collegehumor video with me depicting three women in a nail salon, bragging about what horrible things they’ve done, from eating 13 glazed donuts in a single sitting, to “enslaving the entire office”, in the name of their own self-care. Because, according to the video, “You can be terrible if you call it ‘Self-care’”.

Humorous? Perhaps. An accurate depiction of self-care? Well, no.

I asked followers of my Facebook page to tell me what the phrase “Self-Care” means to them. They enthusiastically replied:

  • “Silence. No social media, or anything electronic.”
  • “Floating in water—buoyant, effortless.”
  • “Being kind and gentle to myself.”
  • “Meditation and time to oneself.”
  • “Eating healthy foods.”
  • “Respecting your body.”
  • “Epsom salt baths.”
  • “Peace.”
  • “Rest.”
  • “Hygge.” (a Danish word that is roughly translated as “warm and cozy”)
  • “Yoga.”
  • “Commitment.”
  • “Masturbation.” (There’s one in every crowd.)

In essence, their responses boiled down to, “Self-care is feeling good, taking care of myself, and taking care of my body, by engaging in activities that feel nourishing while reducing external stress and overwhelm.”

Put even more simply, self-care is the act of practicing self-compassion, whatever that might look like to you.

2) Understand the impacts of stress.

The relationship between self-care and stress is important. According to The American Institute of Stress, about 75% of us have significant physical and psychological stress in our lives.

This stress takes a toll; it produces physical, mental and emotional symptoms, sending us into emergency rooms with panic attacks, and drugstores with prescriptions for pain, anxiety, or anti-hypertensive medications.

Stress lands us in doctor’s offices, pouring over junky magazines waiting to discuss our latest health complaint—digestive issues, mental health issues, fatigue, autoimmune disease, metabolic syndrome, chronic pain, weight gain, and so on.

Our bodies have a built-in stress response to save our lives when triggered by a life-threatening danger. Now, this fight-flight-freeze mechanism is chronically set off by the abundant stressors in our modern era—traffic, deadlines, relationship woes, artificial lighting, and in-laws.

When our body encounters a stressor, one of the hormones it releases is cortisol.

Cortisol affects every system in the body; it elevates blood sugar, heart rate, and blood pressure. It suppresses the immune system, redistributes fat, shrinks certain areas of our brain involved in learning and emotional regulation, causes painful muscle contraction, impairs digestion, and affects our sleep.

Managing stress involves two main goals: lowering external stressors, and managing internal perceived stress by boosting our physical, mental, and emotional resilience. Self-care is our armour against the internal and external stress we put up with daily.

3) Make a list of your nourishing and depleting daily activities.

Let’s try an exercise from Mindfulness-Based Cognitive Therapy. Write down a list of routine activities in your typical day: hauling yourself out of bed, brushing your teeth, eating breakfast, sitting in traffic, working, exercising, making dinner, and so on.

Decide if each activity is nourishing, depleting, or neutral. In other words, does this activity fill your cup or drain it?

For instance, I find that breakfast is nourishing, but less so when I scroll through Facebook feeds or answer emails while eating it. Coffee immediately feels nourishing to me but, hours later, caffeine-fuelled and wired, I often feel more depleted than if I had opted for an herbal tea, or hydrating water instead.

4) Find out what brings you pleasure or mastery.

To get a deeper understanding of your day, determine if the activities that nourish you provide you with pleasure, mastery, or both.

Pleasurable activities feel good in our bodies, and minds when we do them. They bring us positive emotions like safety, calm, peace, happiness, joy, excitement, gratitude, and awe. Sleeping, eating, laughing with friends, cuddling with my dog, and consuming art, are all activities that give me pleasure.

Activities of mastery give us a sense of accomplishment and achievement. We feel that we are developing ourselves and moving closer towards an important goal. When we engage in activities that give us a sense of mastery, we experience our lives to be rich in meaning. Checking things off a to-do list gives me a sense of accomplishment. So does making strides at work, and taking a course, or studying. 

5) Make some changes to your list.

Oftentimes, patients recoil in horror when they realize that their lists contain only depleting and neutral activities. There are no activities in their day that nourish them: either through pleasure or self-development. I ask them:

  • Are there any depleting activities that you can stop doing?
  • Are there more nourishing activities that you can start doing?
  • How can you make a depleting activity feel more nourishing?

Self-care and self-compassion are the agents through which we answer these questions.

6) Set healthy boundaries.

Before we can reduce the invasion of depleting activities in our lives, we must learn to prioritize our needs. Many of us put others’ needs first. We ignore the advice of every flight attendant—we put on everyone else’s oxygen mask before our own. Before long, we run out of air.

In order to nourish ourselves, we need to learn to create healthy boundaries around our energy and time; we need to say “no.” Author Cheryl Strayed writes, “No is golden. No is the kind of power the good witch wields… [It involves] making an informed decision about an important event in your life in which you put yourself and your needs and your desires front and centre.” When we say no to the people, activities, commitments, and responsibilities that drain us, we say “yes” to ourselves.

Think of your list of depleting, nourishing and neutral activities. What activities, if you could just say “no” to them, would bring you immense relief? What would saying no to those activities allow you to say yes to instead?

7) Recognize perceived stress.

Whether or not external events elicit a stress response in our body depends on our perception. Stressful events are woven into how harmful and uncontrollable we perceive them to be, rather than their intrinsic capacity to cause us harm.

Our perception of stress can be influenced by biochemical factors, such as our levels of neurotransmitters, and hormones. It can also be influenced by our mindset, our capacity for resilience, and how far into burnout we’ve begun to drift.

Lowering our perception of stress requires that we practice the skill of mindfulness: being aware of how external situations affect our thoughts, emotions, body sensations, and behaviours. It also requires that we pay attention to our internal physiology: our hormones and circadian rhythms, and inflammation levels, to support our body’s physical capacity to deal with stress.

8) Practice Mindfulness.

A tarot reader friend of mine once said, “It is impossible to be healthy in this day and age without mindfulness.” She was probably right.

Mindfulness helps us lower our perception of stress. It is the act of bringing attention to the present moment, intentionally, without judgement. Through mindfulness we can be intentional about our behaviours: how often we exercise and what it feels like, what certain foods feel like in our bodies, and what activities we engage in.

Mindfulness also allow us to parse out our overwhelmed, worried, personalizing, catastrophizing, black-and-white, future-telling, and negative, thoughts from our body sensations and emotions. We realize that our thoughts are just that—thoughts. Thinking something doesn’t necessarily make it so.

Research shows that mindful meditation strengthens the connections between the rational brain and the emotional brain. It helps us develop awareness of our moment to moment experience. It connects us to our bodies and our emotional states.

There are many different mindfulness techniques. You can do sitting meditations, standing meditations, and walking meditations. You can do mindful yoga. You can wash the dishes mindfully.

However, the simplest way to begin a mindful practice is to sit or lie down in a comfortable position, with an relaxed and alert posture, and focus on the experience of breathing.

Focussing on the breath helps us practice bringing our awareness to the present moment. As we learn to ride the waves of our breathing, we eventually learn to ride the waves of stress that sometimes lap gently at our floating bodies, and other times rock us to our core.

With mindfulness we can begin to relax our resistance to the waves. As Jon Kabat Zinn says, “You can’t stop the waves, but you can learn to surf.” Mindfulness is the surfboard that carries you.

9) Practice self-soothing.

Self-soothing helps us regulate our emotions in the presence of external stressors. Dialectical Behaviour Therapy teaches self-soothing as a means of returning to the “Window of Tolerance”.

When we’re in the Window of Tolerance we’re not in fight, flight or freeze. We aren’t depleted, disconnected and dissociated. We feel relaxed and safe, but also alert and focussed. We are present, in control of our bodies. Self-soothing allows us to enter the window of tolerance by boosting the hormone oxytocin, which helps us feel calm, nurtured, and connected.

To boost oxytocin:

  • Lie or sit in a comfortable position, place your hands on your chest and breathe slowly and deeply.
  • Connect deeply with a trusted other: a person in your life, a pet, or an entity (God, your higher self, a deceased loved one, etc.).
  • Use body weights or heavy blankets on your body.
  • Recite believable affirmations of self-love.
  • Ask someone you trust for a hug.
  • Boost pleasure through engaging the senses: listen to soothing music, savour delicious food, look at beautiful images, touch soft fabrics, and use aromatherapy and calming essential oils, like lavender.

Poet Mary Oliver tells us, “You do not have to be good… You only have to let the soft animal of your body love what it loves.”

Self-soothing requires practicing mindful awareness to recognize if you’re slipping outside your Window of Tolerance. It also involves implementing nourishing rituals that “the soft animal of your body” loves, to release oxytocin, and return to feelings of calm.

10) Balance blood sugar to balance your mood.  

Our blood sugar is complexly intertwined with our other hormones, like insulin and cortisol, but also our neurotransmitters, like serotonin, epinephrine and dopamine, which influence our mood.

More than 1 in 3 American adults has pre-diabetes. This indicates an impairment in our body’s ability to control blood sugar, which throws mood and hormones off balance.

One of the main life-saving actions of the body’s stress response is to regulate glucose in the blood. Fluctuations in blood sugar can trigger cortisol and stress hormone release. Stressful events can also wreak havoc on our body’s ability to control blood sugar.  Regulating blood sugar, therefore becomes a priority for managing our body’s internal stress cues.

To balance blood sugar:

  • Eat a full 20 to 30 g serving of protein and healthy fat at each meal.
  • Eat a large, protein-rich breakfast that contains at least 200 calories’ worth of healthy fats: 1 avocado, a handful of nuts or seeds, coconut oil, full fat yogurt or kefir, 3 eggs, etc., within an hour of waking.
  • Eat snacks that contain 10-15 g of protein. A great snack for balancing blood sugar is a 1/4 cup of pepitas, or raw pumpkin seeds. Rich in protein, fibre and healthy fats, they also contain zinc and magnesium, two important minerals for balancing mood and supporting stress hormones.
  • Ensure that every meal contains gut-loving fibre: eat 2-3 cups of vegetables at every meal.
  • Avoid refined sugars and flours wherever possible.
  • Experiment with Time-Restricted Feeding, leaving at least 12 hours of the day open where you consume only water and herbal teas, to give the digestive system a rest. For example, if you have breakfast at 7am, finish your dinner by 7pm, to allow 12 hours of fasting every night.

11) Calm your stress response through healing your circadian rhythms.

The body’s stress response is tightly connected to our circadian rhythms. Cortisol, the stress hormone, follows a predictable daily pattern, rising within an hour of waking in the morning, and then falling throughout the day. Low cortisol levels at night coincide with the rise in melatonin, our sleep hormone.

Morning fatigue, afternoon crashes, and waking at night, all point to a flattened or altered stress response that has negatively impacted our body’s circadian rhythms. Sleep is also the greatest reset for the stress response. We build up our metabolic reserve and internal stress resilience every night when we rest.

To heal your circadian rhythms:

  • Expose yourself to bright, natural daylight soon after waking.
  • Eat a large, fat and protein-rich breakfast within an hour of waking.
  • Avoid exercising too close to bedtime.
  • Keep blood sugar stable.
  • Practice sleep hygiene: keep your bedroom dark and cool, and reserve your bed for sleep and sex.
  • Avoid blue light after 7 to 8 pm. Wear blue light-blocking glasses, use a blue light-blocking app on your devices, such as F.Lux, or simply avoid all electronics in the evening, switching to paper instead.
  • Try to get to bed before midnight, as the deepest sleep occurs around 2 am.
  • Talk to your naturopathic doctor or natural healthcare professional about melatonin supplementation or other natural remedies to help reset your sleep cycle.

12) Manage Inflammation and nurture your microbiome.

Cortisol, the stress hormone, is an important anti-inflammatory. High levels of inflammation have been associated with mental health conditions like depression and anxiety.

Keeping inflammation levels low not only reduces our need for stress-hormone-signalling, but keeps us healthy. Most chronic conditions, like cardiovascular disease and diabetes, are associated with inflammation.

To keep inflammation levels low:

  • Eat a variety of anti-inflammatory colourful fruits and vegetables.
  • Avoid processed oils like soy and corn oil, whose omega 6 fatty acids are known to contribute to inflammation.
  • Eat healthy fats from avocados, fish, coconut, olives, nuts, seeds and grass-fed animals.
  • Avoid processed foods and fried foods wherever possible.
  • Nurture your gut health by eating lots of fibre, and consuming fermented foods, like kefir and sauerkraut.

Our gut is the seat of the immune system. Keeping it healthy is a powerful preventive measure for keeping inflammation levels low. Our gut bacteria also play a role in our mood and stress-hormone regulation. Therefore, keeping them healthy and happy is essential for boosting our internal resilience against external stressors.

13) Recognize that balance doesn’t exist.

None of us are born cool and collected. Those of us who seem to “have it together” are simply quick to respond to life’s tendency to fall apart. Balance doesn’t exist; as soon as we feel like we have the details our lives lined up, a sharp gust of wind sends them tumbling in all directions. Therefore prioritizing self-care becomes an ever-evolving balancing act that we must commit ourselves to through nurturing our internal resilience.

A poem by Kelly Diels says it best, “when your love knocks you down or your weak ankles trip you up, stop worrying about balancing—‘cuz you’re not — and bounce.”

And bounce.

My Amygdala and Prefrontal Cortex Discuss a Centipede Trapped in the Bathtub

Prefrontal Cortex: …Right, so the deadline for the article is Monday. I can work on it tomorrow morning, but then I also need to schedule time for grocery shopping—what am I going to make for the week to eat? There’s a giant load of laundry in the bin too, which I should get to, maybe I can squeeze that in while I’m writing. Laundry is such an involved process sometimes… I also have that doctor’s appointment on Thursday, then I there’s that package I have to pick up at the post office, and I have to mail out my passport for—oh, right, we needed the bathroom—

Amygdala: Good God, NO!!!! OH IT’s THE END OF TIMES! THERE’S A THING there! A crawly, thing, so many legs, evil legs. We’re going to die!!!!!

PFC: It’s a centipede. Trapped in the bathtub.

A: What’s a centipede?! It looks like an alien. Those legs will crawl up our legs, into our mouths, eyes, under our skin—

PFC: Centipede’s don’t do crawl under your skin. I believe that’s…uh, scabies? Centipedes are relatively harmless. Besides, this one is extra harmless; it’s trapped in the tub. Look, see how he’s struggling to get out? He can’t. Poor guy… It reminds me of a time when I felt helpless…

A: It needs to die, we need to kill it, we can’t go on like this!!!

PFC: What, with a centipede in the tub?

A: It’s LEGS. They’re hideous, it crawls, it’s fast. Oh, God, I hate it. We need to call someone.

PFC: We can’t call someone. We’re a strong, independent 30-something woman. We’ve handled massive spiders as big as our heads in the Amazon, giant Caribbean cockroaches in our granola—

A: LOOK AT IT. It keeps moving… Oh god, I hate it.

PFC: It keeps moving because it’s trying to get out of the tub.

A: AND CRAWL ON OUR FACE. LOOK AT IT’S BILLIONS OF DISGUSTING LEGS!

PFC: Why discriminate against something that has many legs? Hindu gods have an extra set of arms and they’re divine. Remember all the times we wished we had another set of arms so we could hold grocery bags while looking for our keys and texting?

A: THAT’S DIFFERENT THIS… MONSTER—

PFC: —centipede.

A: CENTIPEDE… can’t text. It has nefarious plans for us once it gets out of its white, porcelain prison. WHAT ARE WE GOING TO DO?

PFC: Well, we could just leave it there… he doesn’t seem happy in the tub, though…

A: WE’LL NEVER BE ABLE TO BATHE AGAIN! WHAT IF IT CRAWLS OUT?

PFC: It can’t crawl out. Ok, you’re right, we can’t leave it there. The noble thing to do would be to scoop him out and put him in the garden.

A: NOOONONNONONNONONO GOD NO WE’RE NOT TOUCHING IT!

PFC: Why? It’s small, harmless. It’s trapped. We could use a water glass and a card, or book…

A: NO, NOT THE BOOKS, WE DON’T PLAY CARDS WE’RE NOT TOUCHING IT.

PFC: We could… kill. it.

A: OK OK OK!!! HOW?! How?

PFC: Well, we could squish it? Flush him down the drain? I feel like that goes against our moral principles. And, I’d also have to conclude that, quite frankly, it would be an act of cowardice, the ethically inept thing to do—

A: —which option requires the least amount of touching it and squishiness?!

PFC: Flushing. But it will also result in a slow, agonizing death for the poor creature, who we have decided to persecute for simply being in our tub, and for possessing many legs. I’m not sure of the extent to which a centipede feels pain and suffers, though. I mean, does it suffer like we do? Suffering, after all, is often in the stories we tell ourselves about our expectations and identities, our beliefs about what should be and what we deserve, rather than what is. I don’t know if centipedes have identities or expectations but, if we flush him, he’ll struggle, which means he is resisting what is, which is suffering. Causing suffering to another being is wrong. We can also clearly observe that he prefers to stay alive—

A: SHUT UP AND DO IT! FLUSH HIM!

PFC: It would be wrong. We’d feel bad about it. I would, you would. Let’s put him in the garden, please?

A: NO NO NO FLUSH PLEASE.

PFC: Let’s just leave him, pretend he’s not there and come back later.

A: What if he gets out? Crawls on our face while we’re sleeping?

PFC: I don’t think that’s likely. I think he’s trapped in there.

A: He’s going to die eventually let’s kill him, get rid of him!

PFC: Eventually, like you mean at the end of his lifespan? That’s true. I’m not sure how long centipedes live… It’s also cold outside, I don’t think putting him in the garden would do any good. He obviously came in to escape the cold. We’re seeing more centipedes inside now as the weather changes.

A: OH STOP REASONING and just do it!

PFC: …. ok.

….

PFC: Amygdala, it’s done. It was horrible, we’re horrible brain areas. Are you happy? You don’t have to worry about it anymore. I also made sure I let plenty of water flush down the drain so he can’t crawl back up, even though highly unlikely, I knew you might have something to say about that… Amygdala?

A: …

PFC: Amygdala? You’ve… gone quiet.

A: So how are you going to get your article written, laundry done, groceries bought AND cook something for the week? You also made plans with your friend this weekend and you need to shower in the centipede-infested bathroom, and CLEAN the bathroom, it’s filthy. You’ll never get it done… Fear, dread, overwhelm! IT’S THE END OF TIMES!

And so on.

 

5 Tools for Emotional Wellness and Mental Health

I talk about 5 essential tools for caring for your mental and emotional health. These are powerful self-care practices that can help balance your mind and emotions.

Hello, everybody, my name is Dr. Talia Marcheggiani. I am a naturopathic doctor with a focus in mental health and hormonal health.

Despite the increasing amount of research into mental health conditions and psychiatric conditions, and the increase in interventions and early recognition and pharmaceutical therapies that come with mental health diagnoses, we’re actually seeing more debility in mental health outcomes: more debility, more morbidity. So we’re seeing worsening of outcomes even though we’re applying more interventions.

So, how could this be? You expect that the better the drugs that we’re developing, the less disease we should encounter, if those drugs are actually working to counteract the disease process. We’re not seeing that in the realm of mental health, especially when it comes to the common conditions such as depression and anxiety.

And when it comes to disease in the west, we’re not really winning the war against disease. So, things like cardiovascular disease, cancer, hormone imbalances such as diabetes, hypothyroidism, mental health conditions such as depression and anxiety, ADD and ADHD, infertility, neurological disease such as MS and Parkinson’s, autoimmune disease, such as, again, MS and things like Hashimoto’s Thryoiditis and myasthenia gravis, and immunodeficiencies such as HIV. All of these diseases are on the rise, all of these chronic, lifelong diseases. And so, despite these advances in research and drug development, we’re not seeing an improvement in our ability to manage these diseases or prevent them.

And there is obviously not one simple solution to this problem, but one thing I want to point our attention to is this increase in stress and this connection to stress and the diseases that I mentioned. Obviously it’s not just one cause, that would simplify the entire system to an almost ludicrous degree, but there is an estimation that 75-90% of hospital visits are either directly or indirectly related to stress.

And some of the symptoms of stress, so chronic stress or even acute stress, are an increased heart rate, elevated blood pressure, elevated blood sugar, decreased memory and cognition, disrupted levels of serotonin, leading to depression and anxiety, disrupted levels of the other hormones such as dopamine and norepinephrine, and addiction to stress, so a chance in the opioid receptors and the brain structure, altered hormone synthesis, increased inflammation, altered gut flora, etc., etc., and a change in the immune system. So, basically, every system of the body is affected by stress. And being in a prolonged, acute state of stress is lethal to the body.

So, we can look at the rise of cardiovascular disease and diabetes and the fact that stress increases our heart rate and increases our blood pressure and increases our blood sugar. And we can make some of those connections between the symptoms of stress and the diseases that are increasing in our society.

When it comes to mental health, we see how our neurotransmitters and our brain structure and our gut and our immune systems are affected by chronic stress and we can infer that some mental health conditions are either caused by or aggravated by this chronic stress situation. And, so, by not addressing stress and by not looking into stress and finding healthy ways to manage it, we’re doing ourselves a disservice in the management of these diseases and the prevention of them,

So, there’s a few theories that connect—there’s that Monoamine Hypothesis when it comes to mental health, that people with depression and anxiety have this inherent brain imbalance. So they don’t make enough serotonin, or their brains for some reason aren’t responding to serotonin. Again, it’s a very reductionistic model because it reduces all of the experience of depression and anxiety and conditions such as ADD and ADHD and bipolar down to one single neurotransmitter and it oversimplifies the entire system and the entire constellation of symptoms that people can experience and the life situations surrounding these conditions and the fact that they’re comorbid with things like stress and poverty and childhood trauma and those kinds of things.

But there’s some other theories that we can look at, and some other kind of pieces of the puzzle that we can add to create a more inclusive narrative. So there’s a theory called the Mind-Body Theory and this kind of arises as a counteraction, or a counter-philosophy to what Descartes discovered or decided that he discovered, which was that the mind and body are separate entities—this dualistic hypothesis. We know absolutely that that’s not true but our mind and body are completely connected and that our mind probably doesn’t reside only in our brain because our nervous system extends throughout the entire body and our minds are also inter-relational, so they’re a product our environments and our relationships with other people as well.

We know that the gut is the second brain, for the amount of neurons that it inhabits and the neurotransmitters that influence its function. Our gut health affects our mood depending on how healthy it is. And we call this connection, another word for it, a more scientific word, is “Psychoneuroimmunology”. This is the connection between the immune system, the nervous system, and our psychology, our mood: our thoughts and emotions. So, we know that everything in the body is interconnected and you can’t prescribe an antibiotic and not expect that there’ll be sequelae or consequences, or side effects that affect a different body system. And we see that all the time now, but we have to understand how tugging on one thread in this interconnected web is going to affect another piece of it further down the line.

There’s also this Energetic Model of mental health, and that’s that the emotions have their own energy. There’s this theory that the emotions can manifest as physical symptoms and we see this in the work of Gabor Mate, who writes extensively about stress and addictions and mental health, in his book “The Body Says No”. He talks about how the health of our thoughts and emotions impact our physical stress. And so it’s not just that our thoughts and emotions can impact our mental health, but also our physical health and might set the stage for us to get conditions like cancer, or autoimmune disease, and all of the other diseases that I mentioned.

So, when it comes to stress and our mental health and emotional wellbeing, we need to take a proactive approach. Just like we do with getting vaccinations, and preventing colds and flus, and getting proper nutrition, and exercise and all of that, we need to be strategic about how we manage our stress.

The World Health Organization defines mental health as “A state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” So, notice that this definition isn’t simply the absence of disease and it’s not necessarily a normalizing—being “happy” or not having a diagnosis. This definition is about realizing one’s potential and experiencing emotional “wellness”, for lack of a better word. So, an ability to cope with life’s stressors and to live a life of meaning and purpose.

So I want to talk about 5 tools that are really important for establishing a self-care and emotional wellness routine, for improving mental health. These strategies may not be sufficient enough for more serious psychiatric conditions, but I believe that they form the foundation of proper lifestyle strategies to help with increasing our emotional wellness and our ability to cope with life’s stressors.

So the first one I want to talk about is something called “Self-Care”, which is becoming kind of a buzzword in high-stress communities such as universities, and even some offices and corporations. So, one of the first things I want to talk about is the power of saying “No”. Sometimes saying No, especially for more agreeable individuals, and a lot of the time for women, saying no is a difficult thing for us to do.

When I give this presentation to a group I always ask them, “Why is it hard for you to say no? What would happen if you didn’t say no? Let’s say a friend invites you out and you’re just not feeling it, or you’re invited to a baby shower and it’s just more than you can handle and you wish you could say no, but you don’t.” And, one thing that everybody says is that they’d feel guilty, if they said no. This is sort of universal. And so I ask them, “What would happen if you didn’t say no? What would happen if you went along with it, even if you just didn’t have the energy to devote to this commitment?” And people say that they’d feel resentment. And so when it comes to deciding what things to take on and what things to discriminate against in terms of the tasks that we take on, the commitments that we make, we’re kind of stuck between this dichotomy between feeling guilt and resentment spectrum. One of my mentors, Gabor Mate, in his book “The Body Says No”, talks about when faced with this choice between guilt and resentment, especially when we’re more prone to guilt-avoidance by saying yes more often than maybe we should, he said “choose guilty every time”, because the feeling of guilt, and obviously this isn’t a hard or fast rule, but the feeling of guilt is more indicative that you’re taking care of yourself.

His theory as well is that resentment tends to build up in the body and contributes to the cause of more disease such as cancer and this cancer personality that he writes about is the woman that will say yes to things and is scared to say no out of guilt. So, resentment is far more damaging for the body and therefore, when trying to avoid guilt, maybe move towards guilt, especially when you know that you might be taking on more than you should. And also pay attention to the idea that when we say yes to things we’re saying no to other things. So, we’re always saying “no” and “yes”. We only have 24 hours in the day and so, by saying yes to that baby shower that you’d rather not go to, what are you saying no to? Are you saying no to doing a yoga class for you, or getting extra sleep, or saving your money for a family vacation? So, paying attention to those commitments that we make. There’s a great article online called “The Law of F- Yes! Or No.” And this law is, if you’re faced with a decision and you’re not feeling like this, “F- Yes!”, then say no and save that time and save those commitments for something else that you’re more enthusiastic about.

When it comes to self-care, there’s another great article that talks about the BACE method, so that’s BACE. And this stands for these 4 pillars of self-care. And the first one of body-care. So that’s making sure you have a healthy diet, that you’re supporting yourself nutritionally, that you’re getting movement in, that you’re sleeping enough. A is acceptance, just allowing the emotions, and that self-care, that self-love to come through. C is connection, so establishing those interpersonal relationships and prioritizing them, especially relationships that feel nurturing, where you can be your authentic self. And E is enjoyment, finding activities that are fun and cause a sense of enthusiasm and enjoyment in your life. And this is something that’s often a problem for a lot of adults with lots of responsibilities that, when I ask them to rate on a scale of 1 to 10 how much fun they have, or how satisfied they are with the amount of fun in their life, they often rate it pretty low.

A lecture that I attended, there was a woman who was talking about self-love and improving self-worth and recommends asking oneself this: “what would someone who loves themselves do? Or say?” and that can be pretty powerful for just examining how our internal dialogue is manifesting and how we’re talking to ourselves and treating ourselves. Would someone who loves themselves eat that? Or say that? Or do that activity or say yes to that commitment? And, you know, just sitting with that question can be really helpful for changing some behaviours, or adding perspective to our daily lives.

There’s also this, lastly in the realm of self-care, there’s this idea of Wu Wei, which is a Taoist idea, which is translated roughly into the art of “effortless action”. In our society we’re kind of educated to pair action with effort. So, we don’t feel like we deserve success unless our success was the result of a massive amount of effort that we’ve put in, and stress. And, according to wu wei, this idea that action is objective, we can measure it, but effort is subjective. So, you can see if you’re performing an action, but the perception of effort behind it is this kind of subjective and thought-based experience. So, we can do the laundry or DO the laundry. We can do laundry from a place of self-love and self-care, like “I want to care for my clothes, and to have nice clothes to wear tomorrow and I’m going to do this for myself and I’m going to be mindful as I do it”. And I’m going to do this out of necessity, but also out of a natural drive that’s coming from this place within. Or I can have laundry on my to-do list that’s causing me stress. So, sometimes even wu wei is about doing less and not feeling guilty for that.

The second tool for emotional wellness is journalling and writing. This is one of my favourites. So, journalling allows us to keep a record, to get creative, and to engage in self-expression. And when we write we engage both sides of our brains: the motor centres, the language centres, the centres that are involved in language perception and in language generation, also our visual centres. So, a lot of the brain is lit up in the act of writing and that can help integrate some of our deeper thought processes.

Writing down things leads to clarity and focus. We’re forced to deepen our thought processes and remove ourselves from some of the cognitive loops we might be engaged in. We can complete our thoughts and reach their inevitable, often ridiculous conclusions and this kind of comes from some core beliefs, or, we call them “automatic thoughts.” Like, “I’m a failure” or “I’m worthless”. Those kind of things that our brain generates based on past experiences that may not be relevant anymore to who we are now. Through writing we’re forced to look inside of ourselves, to causes and explanations for how we feel. We’re also able to express ourselves and rid the body of pent up emotions, such as anger and aggression and sadness, shame.

I often recommend that people write a letter. Especially if there’s someone in the past that’s done damage to them, or hurt them. Someone that they miss, sometimes remembering somebody through a letter: sometimes people wish that they could communicate with someone who’s passed away or is no longer in their life anymore and, through this letter-writing, you’re able to.

I also have people write letters to themselves from the perspective of their personality at age 80, and this can sometimes provide perspective for patients who are depressed and young, because it gives them an idea; it increases the perspective of their lives. And sometimes I have people personify and anthropomorphize their problems or addictions and write letters to that or write letters from that and through that process can learn a lot about the relationship between themselves and alcoholism, for example.

There’s another great activity I like called the “God Jar”, for people that have constant worries or wake themselves up at night and process things or who are anxious about the future—The God Jar or the Wish Jar. And so, you get a mason jar and little pieces of paper and you write things that you’re worried about or things that you’re anxious about or thinking about and you scrunch them up and throw them into this jar and, in essence, symbolically, you’re giving those problems to “God”, or to the universe or you’re just simply filing them away for later use. And this is sort of a subconscious, or conscious, dumping of your problems, especially if you don’t have immediate control over them. I mean, in the middle of the night you’re not going to be able to finish your taxes when you’re supposed to be sleeping, or solve a problem at work. And that can often worsen our problems, when we’re not getting enough sleep. Then I sometimes have people open up that jar 6 months later and take a look at some of the things they’ve written and that can also generate feelings of accomplishment and achievement and perspective when you find out that those things that you were so worried about 6 months ago are no longer even relevant and you barely remember them. So, it’s pretty powerful.

Another great exercise is something called a Gratitude Journal. And there’s a Ted Talk about this that, for 21 days, and I like to tell people to do this for a full month, 28 days. If you write 3 things that you’re grateful for at the end of the day for 21 days, it actually changes your brain structure and helps you see things in a more positive light and focus on the blessings, rather than the things that you lack. Our brains have a negative bias. So, they’re wired to pay attention to the things that we’re missing out on and that we’re lacking and when we focus on and acknowledge the things that are going right for us, it can sort of change our perspective. And, throughout the day, as you’re doing this exercise, you’re going to be paying attention to things that you’re going to have to write down later, so you’re paying attention to the things that went well, that you want to include in your gratitude journal. And this can have profound effects.

There’s some studies about journalling. And there was a study that showed that patients with HIV or AIDS, who wrote about their life for 30 minutes had an increased CD4 T cell count—and that’s the cells in the body that are affected by the HIV virus. So, by simply writing about their lives, something profound, it wasn’t just a grocery list. But writing something profound about their lives, such as sharing their life story, actually increased their immune system’s ability to function in the face of the HIV virus.

And then, similarly, there was another study in patient with rheumatoid arthritis—this is an autoimmune condition—they had these patients write for 20 minutes a day, for 3 days, and they found that their symptoms went down and their immunoreactivity went down. So we’re seeing these two studies, and we’re not exactly sure of the causal effect, these studies are a little bit correlative and very difficult to control for, because patients who are in the study, subjects know if they’re writing in their journal or not. But these studies were controlled against people who were just kind of mindlessly writing about grocery lists. So, it was writing about more profound concepts and sort of outlining a significant life event, or life story, or significant events that were happening in the day that had an emotional charge to them.

So, we find that engaging in journalling, even 20 or 30 minutes a day, can actually modulate the immune system. So, if you have a immunodeficiency issue, like HIV, it can increase immunoreactivity, and if you have an autoimmune disease like rheumatoid arthritis, or asthma, if can lower that immunoreactivity and inflammation. So there’s this evidence that journalling and our thoughts and emotions are directly impacting our immune system and our immune system’s ability to function and balance itself.

The third tool for mental and emotional wellness is interpersonal support. And, being a naturopathic doctor who does a lot of counselling in my practice, I tend to favour psychotherapy and counselling as a form of social support for people that don’t feel that they can be authentic or have that deep connection with people in their lives.

There’s evidence that loneliness is the new epidemic, especially in our society and, as social animals, connecting with others is part of our biology, part of who we are. Through therapy, what I really like about it, is it can help us reframe the past and our personal identity. We can start to identify some automatic thoughts and core beliefs, which are deep-seated beliefs that may not serve us anymore in the present and may actually be contributing to feelings of low mood or behaviours that are unwanted. It can also allow us to rewrite our life story, so, looking back on the past and reframing certain events, from the perspective of someone maybe with more resources and power. For example, someone with a history of trauma may have an idea of powerlessness and being victimized and, in every single story of trauma that I’ve encountered, people have always responded in some way. Either psychologically, mentally, emotionally, if not in action, and sometimes just recognizing these responses changes our whole perception of the event and our identities in the present, our ability to act in the present. So, there is evidence that stress is related to our perception of things that happen, not actually what happened. So, for example, imagine somebody that’s just broken up with their girlfriend and they were very in love. And you can image what their mental and emotional state would be like. Maybe the next day they don’t feel like getting out of bed, there’s clothes all over the floor, they haven’t brushed their teeth, they’re feeling extremely sad, and crying. And nothing has changed biologically in this person, but the situation surrounding their life has changed. Then imagine that this person wakes up the next day and they’re in this state of low mood and depression. And they get a phone call. And it’s their girlfriend saying, “you know, I’d like to get back together, I made a mistake, I’m in love with you and I don’t want to be broken up anymore.” So you can imagine that this person’s mood is going to change rapidly as the situation changes. And so, there is a change in their circumstances, but not in their physical biology.

And sometimes, in past events, there’s the story that our minds create around what happened, and then there’s the actual events that happened. So you might call your partner and they don’t pick up the phone, and we start to create a story about why that is. Maybe it’s because they don’t love us anymore, they want to break up with us, that we’re worthless, that no one’s ever loved us, that we’ll never find love, that we’ll always be alone. But, in actuality, we don’t know those things and the only thing that’s happening is they’re just not picking up the phone and there’s thousands of explanations for that.

We perceive situations based on our personal histories, our physical conditions, our state of minds, etc., and things that we’ve learned in the past and also our core beliefs. So, we filter our experiences through our perceptions and our identities and personalities and so, by understanding more about these things, we can understand why we pick out certain events and draw conclusions from the connection between those events rather than others. There’s some people that, when they fail a test, they just think, “Oh, it was a hard test, or maybe I didn’t study hard enough.” And there’s others that think “I’m a failure, I’ll never pass anything, there’s no point in trying, I’m dropping out of school.” And so it’s not just the event but our perception of the event that change our thoughts, mood and behaviours.

Another great thing that therapy and social support can do, is help us identify our passions and purpose in life. So there’s a psychological that I really like to listen to called Jordan Peterson that talks about how the purpose of life is not necessarily well-being and happiness, because happiness is a state that can be derived chemically, through doing things like cocaine, or substance abuse, and happiness might just be a disposition that certain people embody better than others and that life is suffering. And this is present in Buddhist philosophy that no matter how we live, we’re going to encounter events that are devastating for us, and that are hard for us to deal with. And so, in those situations, we’re not going to feel happy, so what’s going to drive us? What’s going to push us forward? What’s going to keep us going in those times and so his theory or idea is that we should look for what makes it worth it: what adds meaning to our life. What is our potential in life? What is our purpose? What gives us that sense of meaning such that, when we encounter these situations of suffering and hopelessness that we’re able to continue on. So, having a direction for our lives, and having a sense of identity and purpose that gets us up in the morning and makes us move forward, even when we’re not particularly feeling happy that day.

Therapy and social support are also great for just self-acceptance. So, having other people mirror back to us who we are and how we’re being in the world.

The 4th tool for emotional wellness is mindfulness and meditation, so very very powerful tools. It’s arguably very difficult to be healthy in this day and age without some form of mindfulness meditation, or meditation practice to combat the increase in stress that we encounter in our society. So, mindfulness is—there’s many different techniques, but the main tenant is just taking the perspective of the compassionate, detached observer to our thoughts, emotions and physical sensations. So, when we split our mind or watch our thoughts, we can get a better sense of awareness of how emotions and thoughts arise in our body, pass through our bodies, and how we’re not them—that there’s this observer role that we can also take, that we can watch ourselves from.

Mindfulness allows us to stay in the present and reframe certain situations and just slow time down so that we’re not victims to the whims of our biology, that we’re able to understand it a little bit more. And there’s a great resource on the internet called “Mindfulness-Based Stress Reduction” that’s a secular kind of meditation by a man in Massachusetts called Jon Kabat Zinn and you can download body scan meditations or take a course in MBSR in your town. I highly recommend them; they’re really great for developing mindfulness practice.

There’s also yoga, and qi gong and tai qi, and these kind of integrated, mindfulness-based and physical exercises that can help slow us down, bring us into the present and help us observe our minds and emotions a little bit better. And there’re amazing for managing stress. There’s good evidence building about them helping us deal with stress and manage our mental health conditions.

And the 5th tool for mental and emotional wellness is to look at that mind-body connection that I mentioned before. The mind-body theory sees our thoughts and emotions as energy that can impact our cellular biology, from that idea of psychoneuroimmunology. And there’s increasing evidence about this and how calming our thoughts down, doing some mindfulness meditation, can affect our heart-rate and can affect our blood pressure, and journalling can affect how our immune system responds.

There’s this idea that if our thoughts and emotions aren’t processed properly they can become trapped and stagnated in the body and contribute to disease. So, Gabor Mate mentioned that resentment can build up and lead to things like cancer. It’s one of his theories that he’s observed through working with patients.

We know that there’s this connection between physical manifestations of symptoms and physical conditions and certain emotional causes. In medicine we know this because every time a study is done, a randomized control trial, two groups need to be divided amongst the subjects. One is given a placebo, an inert pill. And this idea that someone who believes they’re taking medicine will notice a positive effect, is something that we just take for granted, but we build into every single study that we do, if it’s a good study. So, this idea that you can take a pill, believe it’s helping you, and actually physically notice a change in your body is really remarkable. And this just proves that there’s this connection between the mind and body, that we can further explore and exploit.

So, there’s things like herbal remedies that help our body increase our cells’ resilience to stress and help manage the stress hormone cortisol. And these are some herbs called adaptogens. So, they literally help us adapt to stress. And these are things like withania or ashwaghanda, rhodiola, ginseng, even nervine herbs like St. John’s Wort and skullcap can help balance our neurotransmitters and our stress hormones and lower inflammation in the body.

Doing self-care things like getting a massage, or getting acupuncture can help. And there’s a study that compares acupuncture to Prozac, so getting one acupuncture session a week for 6 weeks was actually comparable to Prozac for decreasing symptoms of depression and anxiety.

In my practice I always address diet and gut health and just make sure people are absorbing their nutrients, that they’re guts are producing the proper amounts of neurotransmitters, that there’s the proper bacterial balance, that there’s no inflammation being caused by a gut dysregulation. And we also want to remove those external stressors that can be contributing to an impaired digestive system. So, there is this saying that “we are what we eat,” but more accurately, we are what we absorb, because you can eat a lot of stuff, but, depending on how you’re digestion is functioning, we might not be absorbing all of it and incorporating it into our body, into our cells.

So, inflammation in the gut, caused by a bacterial imbalance, or food sensitivities can impact our health and we have some evidence that depression and anxiety can be caused by some latent levels of inflammation in the brain. And we know that there is an impact on gut health and increasing levels of inflammation and also stress. And really lowering that stress response, healing the gut, can have huge impacts on our mood. Establishing routine, and sleep are major pillars. So, I don’t think I’ve ever encountered a patient who felt mentally healthy when they had disrupted sleep. A lot of the time having a ritual around sleep and getting into a routine and waking up at the same time every day, really working on getting deep sleep—so avoiding electronic use before bedtime, trying to get as many hours before 12 am of sleep as possible, so preferably having a 10pm bedtime or winding down around 10 pm. Doing things like teas, or hot baths, or reading a book before bed or doing some yoga or stretches or meditation before bed to teach the body that it’s time to start relaxing is really important and has huge impacts on health, on our mood, on our emotional wellness, our ability to cope with stress, our ability to heal from stress, and our ability to balance inflammation and the immune system.

There’s evidence that exercise—I mean exercise is arguably the first-line therapy for someone with depression, especially someone under the age of 24. Instead of reaching for pharmaceutical interventions, such as selective-serotonin reuptake inhibitors, more psychiatrists are recommending exercise to young patients, which is wonderful. I’m so happy about that! And, so 30 minutes of a moderate to intense form of exercise such as weight training, or running or moving your body, can help release some of those trapped emotions, as well as boost those neurotransmitters and help our body increase its resilience against stress.

And then, finally, I just want to point out that making sure that we’re supporting our neurotransmitter synthesis through diet is really important. So, making sure that we’re getting enough magnesium, zinc and B vitamins, and proteins and amino acids, which are all helping us create the neurotransmitters like serotonin and dopamine that are going to impact our mood and mental health. So, we can journal, but we are physical beings, and we are a product of our biology. So, by supporting that biology through proper nutrition, we’re able to incorporate those nutrients and create the proper components of our body for proper mental and emotional wellness.

So, I also like to ask people this miracle question. So, this is the final thing that I’m just going to conclude on. The Miracle Question is from a modality called “Solution-Focused Therapy”. And this question is, “if you woke up tomorrow and all of your issues were completely gone, you woke up in an amazing 10 out of 10 state of energy and physical well-being and mental and emotional well-being, what would be possible for you? What would your day look like?” If you can stand in that place and sort of write down what you’re aiming at, what you’re aiming towards, it helps set the stage for taking the proper actions that preserve your mental and emotional wellness. And it also helps you stand in a new territory, one that’s not of disease or illness, but one of possibility.

And, finally, I was at this free meditation circle as we were talking about self-love, and we were talking about how difficult it can be to love oneself. Because, oftentimes we have these core beliefs that drive our psyches and oftentimes these core beliefs are negative. And so what was said was that it’s often hard to stand in a place of self-love when you’re intent on changing things and you’re not happy with where you are now. And so, he said, the person running the meditation said, “self-love is like a garden. So, you can nourish the soil and water the seeds, but you can’t actively force the garden to grow.” So what you can do is, you can take care of the things you love in yourself, all the things that you have in your right now, rather than trying to be somewhere that you’re not currently at. And this is kind of like when you have, for parents out there, if you have a child, you love your 4-year old child, and you don’t put expectations on them that you would a 25-year old. So, you’re loving your 4-year old at where they’re at, but also recognizing that this is somebody who is developing and so you’re loving their potential to develop, just as you’re loving their 4-year old incarnation, their 4-year old manifestation of their personalities. So you’re loving their potential to grow, just as you love the seeds that you’ve planted in your garden, but you’re also loving things where they’re at. And through that act of self-love and tending to the garden, or tending to your child, you’re encouraging that growth and development in the directions that you want.

My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor and I work in Bloor West Village, in Toronto.

Shinrin-Yoku: The Art of Forest Bathing

In this video I talk about the Japanese art of Shinrin-Yoku, or “forest bathing” and how incorporating this practice into your routine can set you up for improved mental health and stress management.

Hello, everybody, my name is Dr. Talia Marcheggiani and I’m recording to you guys from the Humber River in Toronto. It’s December 24th, so it’s Christmas Eve Day and I’m just walking my dog, Coco, and I just wanted to make a quick video to talk to you guys about the benefits of something called Forest Bathing.

So, Forest Bathing is a concept that originated in Japan. In Japanese it’s called, and I’m going to butcher this pronunciation: “Shinrin-yoku”. And this is a practice to relieve stress, which is taken on by the Japanese and is also something that’s gaining more recognition in Western society as well.

One of the theories of the prevalence of chronic stress and symptoms like adrenal fatigue and the hormone dysregulation that comes with that and the mental health issues that come with that is our disconnection from nature. And, so, taking some time—and I recognize sometimes just starting with an hour a week, but optimally three hours a week, of time where you’re just slowly exploring nature and walking in a natural setting such as this. And this is just near Old Mill station in Toronto, and there’s many places like this if you look at Discovery Walks Toronto online you could find tons of really cool places to explore that are a TTC ride away.

And, so, being in a natural setting decreases the stress hormone cortisol as well as increases our ability to get some physical activity. The reason I’m recording it now in December is because a lot of my patients will tell me that they’re really active in the summer months, but when it comes to winter, or when winter months set in, they tend to stay indoors. And the temperature regulation that comes with getting outside, put on a toque, put on a park and some water-proof boots—these are not the best—put on some water-proof boots, a toque, parka, some mittens, and get outside. It helps our body deal with the cold, the decrease in temperature and it can increase our thyroid and our immune system. So, actually getting outside, even when you don’t really want and your intuition is telling you to stay indoors, is actually a good idea for your immune system.

And the stress that comes with the holiday season and this time of year, getting outside becomes more important than ever. So being in a natural setting, in the trees, increases the amount of negative ions that you’re surrounded by, and so when we’re surrounded by technology or are in indoors, stressful environments, there are more positive ions.

Being outside increases your serotonin and oxytocin levels. So, those are your feel-good hormones and it decreases your cortisol. So I just wanted to say hi to everybody and to maybe inspire some of you go for a walk, either today or Christmas Day, and get some Shrinrin-yoku, some much-needed forest bathing.

Having a dog obviously helps. “Coco, Coco, Hey! Look!” Having a dog obviously helps because you’re forced to get outside but even just taking yourself, your kids, your family out, is a great thing to do. Get some snowshoes on, some cross-country skiis, or just some water-proof boots and head out onto the trails.

Happy Holidays. My name is Dr. Talia Marcheggiani and I hope to see you guys outside.

On Emotions and Eating

On Emotions and Eating

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

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

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

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

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

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

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

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

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

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

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

  1. Distinguishing between physiological hunger and emotional hunger:

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

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

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

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

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

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

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

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

3. The Hunger Scale and food diaries:

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

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

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

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

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

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

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

5. Addressing the practical reasons: Planning:

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

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

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

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

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

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

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

7. Addressing the emotional reasons: Nurturing and preventing:

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

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

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

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

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

9. Setbacks: Understanding Change Theory:

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

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

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

On Healing Regret

On Healing Regret

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

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

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

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

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

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

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

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

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

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

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

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

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

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