A Naturopathic Approach to Depression and Mood

A Naturopathic Approach to Depression and Mood

mental healthAccording to Statistics Canada, 1 in 4 people suffer from a mental health condition in Canada. Most of these individuals will fall between the cracks of a medical system that is not equipped to deal with the rise of stress and mood disorders, such as depression.

Naturopathic doctors understand that the mind and body are connected. Science has long established the relationship between the digestive system and mood, often termed the “Gut-Brain Connection” and the connection between the mind, mental health and the immune system, even establishing an entire field termed “psychoneuroimmunology”, linking depression to inflammation in the brain and body. However when it comes to our conventional healthcare model, mental health conditions are treated as separate from the rest of the body. In mainstream medicine, depression is largely treated as a brain chemical imbalance. It is thought that deficiency in the “happy” chemicals in the brain, like serotonin and dopamine, influence mood and must be “corrected” with anti-depressants. Despite emerging science about the brain, emotions, and mood, mental health conditions are commonly viewed as something that has “gone wrong” in the brain.

This reductionist approach to mental health often overlooks the intricate interplay between various physiological systems and their collective impact on mental well-being. For instance, conditions like ADHD are frequently discussed in terms of specific symptoms and brain function, yet they also involve broader aspects of cognitive and emotional regulation. One notable challenge associated with ADHD is time blindness, where individuals struggle to perceive and manage time effectively. This symptom highlights the complexity of ADHD and underscores the need for a more holistic view of mental health, recognizing that these conditions cannot be fully understood by focusing solely on brain chemistry.

Integrating a more comprehensive approach to mental health, such as the one advocated by Healing Psychiatry of Florida, can offer significant benefits. By addressing ADHD time blindness alongside traditional treatments, this approach acknowledges the multifaceted nature of mental health issues and emphasizes the importance of considering how various factors—both physiological and psychological—interact. This broader perspective not only enhances treatment effectiveness but also supports individuals in managing their conditions in a more integrated and compassionate manner.

As awareness grows regarding the interconnectedness of mental and physical well-being, there’s an increasing demand for holistic approaches to health and wellness. Online certification programs in holistic health and wellness, such as those offered by https://it.scholistico.com, play a pivotal role in equipping individuals with the knowledge and skills to address the multifaceted nature of human health. These courses delve into various modalities and disciplines, including naturopathy, nutrition, mindfulness, and integrative medicine, providing a comprehensive understanding of how different aspects of life impact overall wellness.

By embracing a holistic perspective, these certification programs empower students to adopt a more holistic approach to health care, recognizing the intricate interplay between physical, emotional, and spiritual well-being. With a curriculum grounded in evidence-based practices and emerging research, students gain insights into alternative therapies and lifestyle interventions that complement conventional medical treatments. As society increasingly acknowledges the limitations of the traditional medical model in addressing mental health concerns, the availability of online certification courses in holistic health and wellness serves as a beacon of hope, fostering a new generation of practitioners committed to holistic healing and compassionate care.

Most treatments for depression and anxiety are based on the low-serotonin theory of depression, which roughly states that depression is due to decreased production of certain neurotransmitters, such as serotonin, in the brain. Following this model, drugs are prescribed to artificially change neurotransmitter levels. While we understand that anti-depressant medications such as selective serotonin and selective serotonin and norepinephrine re-uptake inhibitors (SSRIs and SNRIs) work better than placebo (in about 40-60% of cases), scientists don’t know for certain why they have an affect. When starting SSRI and SNRI drugs, patients experience an immediate increase in neurotransmitter levels in the brain, however, it takes 2-4 weeks before there are noticeable changes to mood. This points to the fact that the proposed mechanism (increasing neurotransmitter levels) may not in fact be how these drugs work. However, it is in the interest of the pharmaceutical companies manufacturing such drugs to perpetuate the idea that anti-depressant medications are “restoring” the natural chemical balance in the brain, despite lack of evidence that this is the case.

This is furthered by a paper published by the Neuroscience and Behavioural Reviews last year that challenges the low-serotonin theory of depression, stating that improvement on SSRI medication might be the body overcoming the effects of the drug, rather than the drug assisting patients in feeling better (1). This may explain why patients feel worse in the first few weeks of starting anti-depressant medication. The authors venture to say that anti-depressant medication may in fact be creating an obstacle to cure in patients with depression, making it harder for patients to recover in the short-term. The authors of the study argue that most forms of depression provide an evolutionary advantage by providing the body with natural and beneficial adaptations to stress (1).

Since we understand that our digestive system and immune system are linked to our mood and overall functioning, it becomes imperative that we learn how to fuel our brains, improve digestion, balance inflammation and take proactive measures against our increasing levels of stress.

Getting help for a mental health disorder first involves removing the stigma and discrimination around mental health—depression, anxiety and other mood disorders are not signs of weakness, they are common conditions that a large portion of the population is dealing with daily. Next, it is important to seek help from a trusted practitioner who will take the time to listen to your case, treat your body as a whole entity, not just a collection of organs, and connect with you as a person, not just your symptoms or diagnosis. The following are some proposed and effective methods of working with depression and mental health conditions.

1. Healing the gut.

Science has largely started referring to the digestive system as the “second brain”, due to its possession of something called the Enteric Nervous System, a collection of millions of nerve cells that control digestive function and communicate directly with the brain. Because of this intricate connection, research has shown that irritation to the digestive system, through bacterial overgrowth, gut inflammation and a variety of other mechanisms, can trigger significant changes to mood (2,3). Since 30-40% of the population suffers from digestive symptoms such as bloating, flatulence, GERD, IBS, constipation, diarrhea and IBD, this connection is important. Additionally, emerging research is showing the link between beneficial gut bacteria and mood, establishing the fact that certain probiotics are capable of producing neurotransmitters and thereby contributing to mood and mental functioning (2,3).

Naturopathic medicine has long established a connection between the gut and brain when it comes to health, recognizing that conditions such as IBS are aggravated by stress, depression and anxiety and treating the digestive concerns with patients with depression by prescribing quality probiotics and identifying and removing food sensitivities among other things. In addition, not only is gut function important for regulation of the nervous system and, in turn mood, a healthy digestive system is required for proper absorption of the amino acids and micronutrients necessary for synthesizing neurotransmitters.

2. Essential nutrients and adequate nutrition.

If the body doesn’t possess the building blocks for building hormones and neurotransmitters, it won’t make them. While SSRI medication keeps brain serotonin levels elevated, it also depletes the vitamins and minerals responsible for producing serotonin. Supplementing with quality brands and correct doses of vitamins B6, folate and B12, as well as magnesium and zinc and ensuring adequate protein intake, is essential to treating mental health conditions and mood. Some sources state that 70-80% of the population is deficient in magnesium. Since magnesium is needed for production of a variety of hormones and neurotransmitters, a deficiency can cause an array of symptoms from low mood and muscle pain, to insomnia and fatigue. Getting put on high-quality, professional grade vitamins and minerals at therapeutic doses should be done under the care of a licensed professional, such as a naturopathic doctor.

3. Fish oil.

A meta-analysis in 2014 concluded that fish oils are effective at treating low mood and even patients diagnosed with major depressive disorder (4). Since the brain requires the fatty acids EPA and DHA found in fish to function, ensuring adequate intake of fatty fish or using a high-EPA supplement at an effective dose is a cornerstone of natural treatment for depression. The ratio of EPA:DHA is important, however, so ensure you’re receiving a prescription from a licensed naturopathic doctor (not all brands on the market are created equally and some products may even negatively impact mood). Another proposed mechanism of action for fish oil benefitting mood is in its anti-inflammatory properties. Emerging research has suggested that depression may be correlated with low-levels of brain inflammation.

4. Healing the adrenals.

According to evolutionary biology, depression may be a necessary adaptation to stress that promoted our survival and ability to pass on our genes. Since about 70% of the population identifies as being significantly stressed, it is no wonder that the number of mental health conditions is also rising. Naturopathic medicine and other alternative health fields recognize a collection of symptoms caused by prolonged, chronic stress that they term “adrenal fatigue”. Adrenal fatigue is characterized by high levels of prolonged mental, emotional and physical stress, low energy, insomnia, food cravings, and depressive symptoms such as low mood, apathy and lack of enjoyment in previously enjoyed activities, changes to sleep, weight, appetite and energy levels. Whether symptoms of chronic stress are misdiagnosed as mild to moderate depression in people, or whether lifestyle stress is the cause of physiological depression, there is often a significant stressor that complicates symptoms of low mood in most people. Using herbs, nutrition and stress-reduction techniques is important for improving resilience, as is taking steps to decrease the amount of stress present in one’s life. Researching and experimenting with various self-care practices is also important for managing low mood and promoting mental health.

5. Mind-body medicine.

Mind body medicine involves working with the body’s energetic healing forces to remove obstacles to cure and ensure the smooth flow of energy throughout the body. The main modalities that naturopathic medicine uses for these purposes are acupuncture, homeopathy and working with meditation and visualizations. While some reject these streams of healing as being pseudoscientific, there is a growing body of research to back them up. A study by the Journal of Alternative and Complementary medicine showed that acupuncture was as effective as medication at reducing depression after six weeks (5). Mind-body medicine works by integrating our thoughts, emotions and physical sensations to give us more awareness about the body as well as provides us with powerful tools for managing stress.

6. Counselling.

We know that counselling is a preferred first-line treatment for depression and other mood disorders and that counselling and medication in combination is far better than medication alone. While there are a variety of psychotherapeutic models and styles, research suggests that the therapeutic relationship is one of the most powerful determinants of positive health outcomes (6). Therefore working with a clinician that you trust, connect and resonate with is the first step to finding effective therapy. Cognitive Behavioural Therapy (CBT), a style of therapy based on changing ingrained and habitual thoughts, beliefs and behaviours that may be contributing to low mood, is one of the main therapeutic modalities for depression and is supported by a number of studies. Motivational Interviewing is another counselling model that helps patients work through and change addictive behaviours and has substantial evidence behind it.

In addition to established therapeutic approaches like Cognitive Behavioral Therapy (CBT) and Motivational Interviewing, there’s growing recognition of the importance of specialized interventions tailored to specific mental health challenges. For individuals grappling with complex issues such as trauma or relationship difficulties, psychosexual therapy can offer a targeted and effective means of support. This form of therapy delves into the intricate interplay between psychological and sexual health, addressing concerns that may have profound impacts on overall well-being. Moreover, it’s crucial to acknowledge the role of holistic approaches in promoting mental wellness. In essence, the landscape of mental health treatment is diverse and evolving, offering a spectrum of options to meet the unique needs and preferences of each individual on their path to healing and growth.

When seeking therapy, it’s essential to consider not only the specific therapeutic model but also the fit between the therapist and the individual seeking help. For instance, someone in New York City might specifically search for cbt therapy nyc to find therapists trained in this evidence-based approach within their local area. However, beyond geographical considerations, finding a therapist with whom one feels a genuine connection and trust is crucial for therapy to be effective. This connection forms the foundation of a therapeutic relationship that can support individuals in navigating their mental health challenges and achieving meaningful change.

7. Mindfulness.

More and more research is coming out about the Buddhist practice of mindfulness meditation for preventing depression, managing stress, working with mood disorders and preventing relapse in major depressive disorder. Recent evidence published in JAMA has shown that Mindfulness-Based Cognitive Therapy (MBCT), a form of secular mindfulness meditation was just as effective as medication for treating mild to moderate depression (7). Mindfulness involves looking inward, without judgment at the thoughts, feelings and physical sensations produced by the body. Practicing it cultivates the skills of awareness, attention and presence. According to Jon Kabat-Zinn, one of the founders of MBCT, “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgementally. It’s about knowing what is on your mind.” Mindfulness improves mood by allowing participants to better understand their own emotional states without getting caught up in identifying with negative emotions and belief systems.

If you or a friend or family member is suffering from a mental health condition, it is important to be educated about options. Naturopathic medicine is a great first-line option for those who have been newly diagnosed with a mood disorder, as well as a preventive measure for those simply dealing with stress, and a great complement to those who have been living with a mental health condition for some time and are already on medication. I work with children, adolescents, adults, pregnant patients, postpartum women and patients dealing with addictions. I have additional training in motivational interviewing, mindfulness-based stress reduction, narrative therapy and CBT and structure my visits to allow for more time for counselling. Contact me for more information on how to work with me.

References:

  1. Andrews, PW, Bharwani, A, Lee, K.R., Fox, M, Thomsom, JA. Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response. Neuroscience & Biobehavioral Reviews, 2015; 51: 164
  2. Dinan, T, Cryan, J. Regulation of the stress response by the gut microbiota: Implications for psychoneuroimmunology. Psychoneuroimmunology (2012) 37, 1369-1378
  3. Wang, Y. Kasper, LH. The role of micro biome in central nervous system disorders. Brain Behav. Immun. (2014).
  4. Grosso G, Pajak A, Marventano S, et al. Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials. Malaga G, ed. PLoS ONE. 2014;9(5):e96905. doi:10.1371/journal.pone.0096905.
  5. Sun, H, Zhao, H, Ma, C, Bao, F, Zhang, J, Wang, D, Zhang, Y. and He, W. Effects of Electroacupuncture on Depression and the Production of Glial Cell Line–Derived Neurotrophic Factor Compared with Fluoxetine: A Randomized Controlled Pilot Study. The Journal of Alternative and Complementary Medicine. September 2013, 19(9): 733-739.
  6. Siegel, D. The Mindful Therapist. Mind You Brain, Inc. New York: 2010.
  7. Goyal, M, Singh, S, Sibinga, ES, et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med.2014;174(3):357-368. doi:10.1001/jamainternmed.2013.13018.
Will That Be Form or Function Today?

Will That Be Form or Function Today?

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

 

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

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

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

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

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

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

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

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

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

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

Stories of Street Medicine

Stories of Street Medicine

New Doc 29_1I was recently told that a benefactor would contact me about the work I’ve been doing for the Evergreen Yonge Street Mission in Toronto—I provide naturopathic services to street-involved youth twice a month in the drop-in health clinic. There is a natural health company that might be interested in sponsoring some of the naturopathic services. However, in order to understand where their money is going, they want to hear some success stories before they consider if and how much to donate. Are the services working? They want to know. Since I, more than anyone, appreciate the power of a story and, since I’m trying to raise some money to expand the services I provide myself, I thought I’d tell one. Names and details have been changed.

A shift at the mission lasts a few hours. Youth sign up for the adolescent medicine specialist and her Sick Kid’s Hospital resident, dental work or me, the naturopath, represented under the heading “naturopathic medicine/acupuncture”. There is no money for supplements—and supplements can be expensive—and the youth I treat don’t have money to buy food let alone a bottle of melatonin. So I do acupuncture.

Eduardo was waiting when it I called him. He was lying face up on the bench in the waiting area, looking at a pamphlet on “dope addiction”. He was wearing sunglasses. When he came into the visit, he didn’t take them off, despite the low-level lighting of the treatment room I occupy. It felt strange to talk to someone’s dark glasses, not making eye contact with them as we spoke. I wondered vaguely if I should tell him to take off the glasses, and then left it alone—his comfort as the patient should take priority over mine. Why challenge his autonomy and further push the power imbalance by telling him to do something that was not fully necessary? I worked around the glasses, moving them aside slightly in order to needle the acupuncture point yin tang, located between the eyebrows. The glasses stayed on. So be it.

Eduardo and I spoke Spanish, as his English wasn’t strong. He spoke of feeling shaky, showing me his tremoring hand to prove it. When did the shakiness start? I inquired. When I overdosed on crack, he explained. Well, that would do it, I thought to myself, although you can imagine my clinical experience with crack overdose was limited—there aren’t that many crack overdoses in Bloor West Village.

As it turned out, Eduardo had a significant dependence on marijuana, smoking 7 grams a day while in his home country. When he bought pot on the streets in Toronto, however, he found one deal laced with crack. He ended up in the hospital after smoking it. Another time, his weed was laced with meth.

He held his hand up. I watched it shake. He told me his whole body felt shaky. This would be exacerbated further if he stopped smoking marijuana, he assured me. Had he ever stopped before? I asked. Yes, he said. Why did he stop? I asked him, taking a de-centred approach while staying curious about preferred ways of being. In this case I suspected he preferred to be sober—after all, something had made him stop.

The cost, he explained.

Ah, that, I thought. Well, it makes sense.

Eduardo’s experience highlights the complex relationship people have with substances, and the challenges they face when it comes to finding alternatives that suit their needs. For many, the search for a healthier, more manageable way to deal with stress or cravings can lead them down unexpected paths.

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Any other reason? I asked him.

He explained that his family didn’t approve. I asked him why. What might they think of marijuana? What did they see him do when he was high that led to their disapproval. Eduardo couldn’t answer. He changed the subject and explained he’d gone back to weed after quitting it that time because it helped him sleep. Since the episode with the crack overdose, though, sleep was difficult. That’s why he was here: to get acupuncture to help with sleep.

Eduardo spoke in a low voice, often responding with a word or two. Despite the glasses shielding his eyes, he kept his gaze on the floor. When I had him lie on the treatment table, I encouraged him to close his eyes and rest while the acupuncture worked.

After a few minutes, I removed the needles. He thanked me shyly and left. Like many of the people I treat, I figured the odds were high I’d never see him again.

I was surprised, then, that a month later, I saw him in the waiting area again.

The visit went pretty much the same way as the first with one key difference. The second time he came in, Eduardo removed his glasses, meeting my eyes for the first time.

I was touched.

His sleep was still bad. His mood was still low. He hadn’t smoked crack for a while. He was living in a shelter; his family had kicked him out because of his addiction to marijuana. He implied great trauma in his home country, however he didn’t say much more about it. He mentioned regretting that his English was poor—it had been traumatic to come to Canada.

He told me he was applying for medical marijuana. It would be a safer way to smoke, he told me.

He was practicing harm reduction on himself. I asked him if he considered this “taking steps.” He nodded. I asked him about any other steps he’d been considering. He mentioned swimming. Swimming had been a passion of his in his home country. I got more details about his goals: how often did he want to swim? Where? He decided that 3-5 times a week at the local pool would be ideal. I asked him what he’d first have to do to make that happen. Check the pool times, he answered.

I asked him if he’d ever considered quitting marijuana. He said no, he needed it to sleep and to manage his anxiety. But, you know, it was expensive. And, of course, he repeated, his parents had an issue with it. That was a problem for him. I asked him why it was a problem.

It’s a problem… he repeated. He said nothing more.

We did more acupuncture. He went on his way.

Two weeks later, Eduardo came to see me again. He took his glasses off as soon as he saw me.

He reported his sleep was better. He had been swimming 3 times a week at the local pool. He hadn’t smoked crack in a month. He’d stopped marijuana the last time he saw me. He hadn’t smoked for two weeks. He showed me his hand. It wasn’t shaking.

Do you think these are positive developments? I asked him.

He shrugged nonchalantly but failed to disguise the smile that tugged at the corners of his mouth. He looked down.

I put in some acupuncture needles and asked him what his next steps might be. He answered that he thought he might call his old boss back and get back to work. Then he wanted to save money so he could move out of the shelter he was in.

He then started to talk a little bit about his brother who was killed in his home country and his friends who’d betrayed him to another gang resulting in him having to flee for his life. He talked about receiving premonitions in his dreams. This made sleep difficult, but it had also caused him to act and avoid harm—he’d learned from a dream that his friends were untrustworthy. We wondered together if this was more than a source of anxiety, but a special skill that kept him safe. Maybe he wouldn’t have to be vigilant if important warnings came to him in his dreams. I wondered if marijuana, along with helping hims sleep had hindered that gift. He thought about that for a while.

When he left he asked me how many more acupuncture treatments he might need. I told him to come in as often as he liked but 8-10 was a good starting point.

Ok, he said, it’s been 3 so far.

Right, I said. It’s been 3.

Ok, he said. See you in two weeks.

He put his glasses back on and walked out into the chaos of Yonge Street. There was a street festival going on.

At one point in my time spent with Eduardo, one of the staff at the mission inquired about his mental capacities. Apparently the psychiatrist he’d been working with was considering a diagnosis of mental retardation or severe learning disability–it was taking him so long to learn English and he was often slow to answer questions.

No disrespect to psychiatry: the more I work with mental health, the more respect I have for the utility, albeit limited, of psychiatric assessments and medications. For many people, and when applied delicately and sensitively, these things add powerful meaning and serve as important life savers. However, I want to emphasize the importance of lowering practitioner power, understanding the challenges another person may face in their life and respecting the autonomy, decision-making power and special skills of the individual who seeks health care. In addition, rather than looking for the problem in the person, what success stories are they bringing forth? What goals have been set and what steps have been taken already?

I often comment that the stories I hear and the conversations I have in the work I do are not the least bit depressing. Sure, the youth have dark, complicated, often horrific pasts. However, every individual is a collection of hopes, dreams, goals and personal strengths and abilities. Every person that comes to see me wants something more for themselves and has already exercised an ability to move closer to their preferred ways of being in the world, showing me the incredible capacity for human strength and endurance. The only difference, between the perspective I get to enjoy and the one seen by other health professionals, however, is that I look for stories of strength. Because strength is always there, waiting for a thoughtful question to bring it into the light.

To contribute to the Yonge Street Mission naturopathic services and for more information on the campaign, please click here. Donations are made in USD.

DIY Rosemary Wine Tincture

DIY Rosemary Wine Tincture

IMG_5512

As a student of naturopathic medicine, I didn’t quite get herbs. They were natural, sure, but why would I prescribe them in lieu of homeopathy, dietary changes or nutritional supplements? I didn’t get it.

I liked herbs; I understood the idea of synergy—the fact that the effect of the entire plant is greater than the sum of its parts. Also, I knew that plants often have superior effects to some drugs in that they often contain active ingredients that balance the side effects otherwise caused by most pharmaceutical medications. For example, anti-inflammatory herbs like turmeric and licorice root also support and strengthen the immune system, rather than suppress it, as most anti-inflammatory drugs tend to do. For most drugs that lower inflammation, a common side effect is severe immune deficiency. This is not the case for herbs that lower inflammation, which actually benefit the immune system. So, I knew herbs were cool.

I also liked the idea that each tincture was individually created for the totality of symptoms a patient presented with. Creating a specific medicine for each individual seemed to fit with the idea of singularity in medicine, which I resonated with. However, for a long time I didn’t get herbs. And I’ve often been reluctant to prescribe herbs in my practice.

First of all, I don’t have my own dispensary so sending patients off to buy tinctures created a kind of disconnection from the source of my prescriptions. Secondly, as many of you who have tried it can contest, tinctures (or herbs extracted in alcohol) taste terrible and make compliance hard, even for myself. Thirdly, tinctures are quite expensive. Each 50 ml of tincture can cost upwards of $5 making a month’s supply of herbs quite costly. This is funny because many of the herbs that are so costly to buy grow like weeds in southern Ontario (dandelion, for example, is often considered a weed) and tinctures aren’t that difficult to make. Fourthly, I didn’t like to prescribe tinctures because, as I understood it, people would only feel better while actively taking the herb. In my mind, the herb worked like a drug in that once you stopped taking it, the positive effects would diminish. This differed from my understanding of homeopathy, which stimulates the body to heal itself, correcting nutritional deficiencies or looking for and treating the root cause of symptoms. I doubted whether the way we were taught to prescribe herbs did in fact treat the root cause. This is important because the guiding principles of naturopathic medicine dictate that we aim to do this whenever possible.

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I had no doubt, however, that herbs were effective. Taking a tincture seemed to be far more effective for me and the patients I treat than taking supplements. Herbs are nutritional—they are a food and a medicine and therefore contain a myriad of health benefits beyond treating what they are prescribed to treat.

It wasn’t until I read author and herbalist Matthew Wood’s works on herbalism that I began to internalize the idea that herbs do in fact stimulate the body to heal itself. Plants contain an inherent wisdom, according to Wood and his studies in western and Native American herbalism. Plants eradicate disease by stimulating the healing powers of the body and strengthening the body’s capacity to heal itself from disease. The body is constantly trying to heal itself from ailments and, when these processes become blocked for one reason or another, disease symptoms begin to manifest. Herbs can strengthen the body’s healing processes, when prescribed in a certain way, and large doses for long courses of time are not necessary. Further, once the disease is eradicated, the herbs can be stopped. When prescribed as a healing catalyst, disease doesn’t return once the herbal prescriptions have done their work.

Wood writes, “It should be understood that herbs can be used either way: to stimulate the self-healing powers of the organism to return to health, or to artificially manipulate the organism to fit an artificial goal.” He uses the examples of goldenseal, which at high doses can kill bacteria or viruses that have invaded the body and in smaller doses can increase the mucosa and digestive systems of the body to rid itself of the invaders and, in turn, strengthen the body against future invasions.

In regards to the cost of herbal tinctures, there are relatively simple ways to get the effects of herbs by making your own tinctures.

Read on to support liver detox, hormonal health and cardiovascular health by creating your own rosemary tincture using dried rosemary, one of my favourite herbs of the moment, and a bottle of white wine:

Rosmarinus officinalis, is the latin name for rosemary, a member of the mint family. While better known for its ability to perfectly complement roast chicken, it has a number of health benefits. Rosemary’s energetic actions are stimulating and warming, according to Matthew Wood. It clears up phlegm and dampness, stagnation and sluggishness in the tissues.

Rosemary has the ability to boost metabolism and increase the absorption of sugars and fats, which make it an appropriate nutritional supplement for people with diabetes. It can help drive glucose into the cells, diminishing the need for the body to release large amounts of insulin, re-sensitizing cells to insulin and lowering blood sugar. It can help nourish the entire body and has a special affinity for the heart, lungs, spleen, liver and kidneys.

Rosemary is currently often used to detoxify toxic, exogenous estrogens from the body while promoting the conversion of health-promoting estrogens in the liver. It is a powerful stimulator of liver detoxification. It therefore serves as a cheap and useful remedy for seasonal, full-body detoxes or coming off oral contraceptive or synthetic hormones, such as the fertility drugs given before IVF treatments. It is also useful for promoting circulation and lymphatic drainage, moving sluggishness and excess weight and creating warmth and vitality in the body’s circulatory systems.

Herbalists use rosemary tincture or oil applied topically to the head and neck to treat migraines from tense shoulder and neck muscles. Its scent is aromatic and stimulating and can improve memory and cognition. It is an effective remedy for mental-emotional depression when taken internally, especially where patients feel damp, sluggish, lack motivation and experience feelings of mental dullness.

As a digestive aid, rosemary can help relieve abdominal bloating and flatulence. It also helps stimulates appetite. It helps burn up phlegm in the stomach and can aid in weight loss.

In addition, rosemary contains antimicrobial properties, meaning it can be used to kill bacterial and viral infections, especially when taken at the beginning of a cold.

It is a powerful heart tonic, especially where there is edema and circulatory stagnation, such as early signs of congestive heart failure. It also can help with arthritic pains and joint stiffness when applied topically to joints or taken internally as an anti-inflammatory.

In Matthew Wood’s book, The Practice of Traditional Western Herbalism, he recommends creating a rosemary infusion (infuse fresh leaves and flowers in a pot of boiled water and keep covered) or a tincture using white wine as the alcohol base.

A few days into taking this tincture (mixed with a little water to dilute the strong taste), I’ve noticed my skin clear, my digestion improve, my stomach flatten (I no longer have any bloating and I’ve been experimenting with eating wheat again for the first time in years), and my energy increase. My symptoms of PMS this month subsided before my period even came. I had a canker sore in my mouth that immediately went away once I started taking rosemary wine. I’ll certainly be adding this cheap and effective DIY remedy to my self-care and general health-promoting regime.

Here’s how to make your own.

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Rosemary Wine:

Ingredients:

1 handful (approximately 250 ml) of rosemary leaves, dried, cut up as small as possible (you can use a packet of rosemary spice from the grocery store). Extra points for organic.

1 bottle (750 ml) of white wine (Wood recommends a good quality wine, I used a cheap homemade one I was given as a gift).

1 empty glass bottle/jar

Directions:

Put rosemary in the empty glass jar. Pour entire 750 ml bottle of white wine over rosemary and let stand in a cool, dry place for 2-3 days. Then strain out the herbs and store the liquid tincture in a cool, dry, dark place, like a cupboard.

Talk to your naturopathic doctor about appropriate dosing, though most botanical prescriptions involve 1 tsp of tincture 2-3 times a day away from food. This will vary according to your health challenges and health goals, among many other factors.*

Reference:

Wood, Matthew. 2004. The Practice of Traditional Western Herbalism: Basic doctrine, energetics and classification. Berkeley, California: North Atlantic Books.

*This article is not to be confused with medical advice from a licensed naturopathic doctor. If you suffer from one of the above-mentioned conditions and believe rosemary might help, please book an appointment to receive an appropriate assessment. 

 

 

Naturopathic Narrative Therapy

Naturopathic Narrative Therapy

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

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

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

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

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

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

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

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

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

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

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

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

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

These kids have a lot to be angry at,

my supervisor had said.

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

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

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

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

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

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

It definitely would have been life-affirming. 

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

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

Narrative therapy is therapy that is life-affirming.

And there is something very healing in a life affirmed.

More: 

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

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

Book: Maps of Narrative Practice by Michael White

 

How to Reinvent Your Life in 20 Steps

How to Reinvent Your Life in 20 Steps

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

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

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

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

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

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

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

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

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

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

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

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

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

10) Exercise. Enjoy some movement every day.

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

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

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

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

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

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

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

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

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

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

The Estrogen Metabolism Diet

The Estrogen Metabolism Diet

New Doc 8_8Estrogen is the dominant female hormone. It is actually a group of hormones, called the estrogens, that are responsible for the development of female secondary sex characteristics: the development of breast tissue and the proliferation of the uterine lining. Estrogen helps prepare the body for ovulation. Not all estrogens are created equal, however. Some estrogens are associated with an increased risk of certain female cancers, such as breast cancer.

Excess estrogen, especially in the form of these so-called “bad” estrogens, seems to be a common theme among women in North America. Stress, caffeine intake, synthetic estrogens in birth control pills and hormone replacement therapy and xeno-estrogens from cleaning products, plastics and cosmetics are among some of the causes of excess levels of estrogen in the body. Because of these environmental factors, many women suffer from something called “Estrogen Dominance”.

Symptoms of estrogen dominance include stubborn weight gain, anxiety, premenstrual symptoms of breast tenderness, acne, irritability, fatigue and brain fog. Estrogen dominance can contribute to worsening of health conditions such as infertility, fibrocystic breasts, repeated miscarriages, uterine fibroids and endometriosis as well as increase the risk of developing certain cancers.

Estrogen detoxification can be done effectively through a healthy diet that aims at improving estrogen clearance in the liver and regulation of the action of estrogen at cell receptors. By following this diet, patients can experience an improvement in hormonal health conditions, clearer skin and weight loss.

This diet is adapted from Dr. Joseph Collins RN, ND at yourhormones.com.

Cruciferous vegetables: Vegetables from the cabbage family, such as cabbage itself, cauliflower, broccoli, brussel sprouts, kale, bok choy, spinach, collard greens and other leafy greens are rich in a nutrient called indole-3-carbinol, or I3C. I3C gets converted to diindolymethane (DIM) in the body, which is responsible for clearance of excess estrogens in the liver. Consume a minimum of 3-4 servings of these vegetables per week.

Rosemary: Rosemary, when added to meats as a seasoning enhances the formation of good estrogens (the ones less likely to cause cancer or health concerns). Rosemary has the added benefit of antioxidant activity. It also enhances memory and mood and helps with thyroid function, improving weight loss, metabolism and energy levels.

Flaxseed: 2-4 tablespoons per day of ground flaxseed promotes healthy estrogen metabolism. The seed contains lignans, which help clear excess estrogens from the body. Flax also contains phytoestrogens, which control how much estrogen can bind to estrogen receptors. This means it can decrease excess estrogen activity or increase deficient estrogen activity, making it an effective remedy for a variety of female health complaints. Flax is rich in healthy omega-3 fats and contains fibre, making it an important remedy for treating inflammation and constipation. Flaxseed is digested and absorbed when ground, and best stored in the fridge as the oils in the seed quickly go rancid at room temperature.

Salmon and other fatty fish: Salmon and other fatty fish contain EPA, an omega-3 fatty acid, is an important anti-inflammatory oil. It has been shown to be effective in treating inflammatory conditions, cardiovascular disease and mental health conditions, such as depression, anxiety and ADHD. It helps increase the formation of “good” estrogens in the body. Enjoy 2-3 servings of fatty fish per week, or supplement with a quality fish oil.

Isoflavones: Isoflavones, such as those found in soy, are antioxidants effective at increasing good estrogens in the body. Since soy is often heavily processed, using herbs such as Trifolium pratense, Pueraria montana and Pueraria lobata either in teas, capsules or tinctures, will help provide an adequate dose of isoflavones.

Activated folic acid: Folic acid is responsible for converting estrogen into a very healthy, methylated form that can decrease the risk of certain cancers. Many people are unable to convert folate into the active 5-methyltetrahydrofolate, which is essential for hormone metabolism, DNA synthesis, homocysteine metabolism and nervous system function (good mental health, memory and energy). Other B vitamins to supplement with are B6 and B12 as they help folic acid metabolism estrogen into their anti-cancer form. Folic acid is found in dark leafy greens, which also contain your daily doses of indole-3-carbinol.

If you are experiencing symptoms of estrogen dominance in the form of a female health complaint, book an appointment to learn what else you can do to experience healthy, happy, pain-free periods and look and feel your best. Contact me. 

Self-Care and Political Warfare

Self-Care and Political Warfare

IMG_5332I was in an emotional crisis. My partner and I were fighting. It was my fault and the anxiety I endured from the confrontation was compounded by a deep sense of guilt and shame. I felt powerless as I waited for him to reach out to me so we could fix the problem while at the same time dreading the future confrontation we’d have. I felt isolated. My nerves were shot.

I texted the problem to my friend, A, the psychotherapist, while sitting on the couch in my pyjamas. At the time I remember wanting to include others in my misery, so that people would ask me about it and tell me everything would be alright, that it happens to all of us—it wasn’t that bad—and that I’d get through this thing.

A tells me, “There is nothing you can do now but wait. Waiting takes courage. So, while you’re waiting, don’t forget to self care.”

Self-care: the illusive term we’d often hear tossed around in naturopathic medical school. The hyphenated compound noun referred to anything from applying castor oil packs to getting enough sleep. In my mind, it brings up images of spa-like indulgences: bubble baths, candles, a junky novel—guilty pleasures. True self-care, however, is far from simple self-indulgences. Audre Lorde owns the most powerful definition of self-care I’ve heard, which is this:

“Caring for myself is not self-indulgence, it is self-preservation. And that is an act of political warfare.”

Rather than being a commercial phenomenon—involving trips to the spa, chocolate binge-eating and shopping sprees—self-care is political. Self-care challenges the inequality and oppression of race, gender, class and sexual orientation in society, by providing us with a means to improve our strength and ensure our survival.

When I read Lorde’s quote, I think of my Italian grandmother Nonna. Barely sitting down to enjoy the dinner she had prepared, she dedicated herself to the service of her family’s well-being. Like many other women, especially Italian Catholic women from her generation, she had been taught that any care for herself was selfishness—a symbol of the highest level of vanity and self-obsession. Nonna, like other women of various colours, religions and socioeconomic statuses, was taught to live a life of self-sacrifice. Any attention paid to her own well-being was regarded as an indulgent after-thought. Women are denied a societal sense of self-worth, which is then paradoxically medicated by advertisers telling us to “treat ourselves” to expensive perks because we’ve “earned it”. We are taught not to love ourselves and then instructed how to remedy this lack of self-love with expensive gifts.

Self-care is about finding ways to cultivate and feel deserving of self-love.

True self-care is essential for moving us forward. Because it prioritizes the health and well-being of a person, it affirms self-worth. This has the power to challenge the oppressive forces of racism, misogyny, classism, homophobia and other prejudices. Self-care helps with trauma recovery. It helps heal.

Self-care builds resilience.

We commonly fall into the thought-trap of regarding self-care inaccessible to certain populations; we assume it requires time, money and energy that not all of us have. Katherine from “I Am Begging My Mother Not to Read This Blog” accurately expresses the sentiment with an ironic twist:

“Make time for yourself. After you’ve run that 5K, started a load of laundry, harvested your organic vegetable garden, run to the bank, paid the bills, dazzled everyone with recipes that are cost-effective, healthy, and delicious, thought of something witty and clever to share with your social networking site, caught up on current events and politics, and cleaned all of the house, that special hour set aside just for you is so critical to your well-being.”

While she certainly has a point, something essential is missed in the definition of self-care. Self-care isn’t about shutting out the sound of your screaming children while you pour yourself a martini and fill the tub with hot water. Self-care is about intention, balance, mindfulness, self-awareness and, above all self-love. It is about taking responsibility for one’s own health and well-being. It is about recognizing your physical, mental and emotional needs and ensuring that those needs are met. Self-care is about reducing stress levels. If a pile of dirty laundry is stressing you out, then mindfully washing those clothes while watching the stress leave your body is self-care.

Self-care is an attitude. You can wash your dirty laundry with the frenzy of a thousand cortisol molecules and your mind on the massive list of other things yet to get done, or you can savour the positive feelings of achievement that comes from checking an item off the to-do list. You can breathe the scent of fabric softener, feel the warmth of the clothes that are coming out of the dryer and acknowledge that you are caring for yourself by ensuring you have clean clothes to wear the next day. It’s perspective and intention that creates self-care. That being said, laundry doesn’t necessarily have to be your thing either.

I have a patient who works 6-day weeks. When I asked her what she does for self-care, she looked at me, puzzled. “You know, self-care—how do you take care of yourself?” I tried to clarify. There was still no dawning of realization on her face. I silently chided myself for asking such an insensitive question.

And yet, my patient was taking care of herself. She was drinking more water, eating more vegetables and exercising. She was coming to see a naturopathic doctor and investing in her health. She was doing plenty of self-care; she just didn’t know it.

The SCaR Foundation outlines the BACE method of self-care, which helps us draw awareness to the simple acts we can engage in to care for ourselves.

Body Care involves exercising regularly, eating healthy food, taking medications and herbal supplements as prescribed. It also encompasses getting up to stretch while sitting at a desk, drinking water, getting enough sleep.

Achievement consists of finishing the daily tasks you have on your to-do list, laundry among them. It also includes working towards goals, like studying for a test or doing your work.

Connecting with Others includes spending time with friends, family, or a pet. Social connection is one of the reasons why we’re alive. Being able to reach out to others for help is one of the strongest manifestations of courage and resilience.

Enjoyment encompasses hobbies, favourite pass-times and indulgences. What activities bring joy and happiness to your life?

Self-care should not be pre-determined. When it becomes someone else’s prescription, it is no longer self-care.

Self-care is not always pleasurable. Sometimes it can be quite uncomfortable, such as making the decision to change careers, end a relationship or get in shape. It can be transformative, such as standing up for yourself. Self-love is a revolutionary act and revolutions aren’t always won peacefully. However, learning to listen to the body allows us to determine which decisions are coming from a place of self-love and not anger, hatred or fear.

My particular self-care story ended well.  The very act of reaching out to a friend had already begun the process of self-caring (connection). After talking to A, I got up, changed out of my bathrobe, exercised, showered, and put on a homemade face mask of yogurt, honey and avocado (body care). I read fiction on the couch with a hot mug of cinnamon tea (enjoyment). I did yoga, meditated (body care) and went to a friend’s house for lunch, then another friend’s for dinner (connection). I took a course on a subject I love and met other healthcare practitioners while developing a new counselling skill (achievement). A part of me craved isolation, but I intuited that wouldn’t be a restorative act for me at that time and so I forced myself to move on with my activities, knowing that they would improve my positivity and resilience. In the end, because I took care of myself, I was able to face the situation from a place of strength and compassion for both me and my partner. Self-care helped me move past the shame and connect to the most powerful and loving version of myself.

That was my approach to self-care, because it was what I needed. At that time, I needed to feel healthy, strong and social. I needed to be reminded of who I was. Others in similar situations may decide that they need to grieve alone while watching When Harry Met Sally and devouring wine and popcorn, their faces stained with tears. Self-care is about knowing yourself and recognizing and honouring your needs.

Contrary to what we’ve been told, self-care isn’t selfish. It is the highest expression of connectedness. We can’t take care of others if we are not healthy. And we can’t be healthy without taking care of ourselves.

Self-Care Resources:

Methods-of-Self-Care : Free Ebook

Caring About Self-care : Article

Also, check out this Self-Care Journal, by Rachelle Abellar. It has sections for personal affirmations and action plans for when you’re feeling low. You can buy a copy at lulu.com.

Healing Within the Therapeutic Relationship

Healing Within the Therapeutic Relationship

New Doc 7_4My classmate, A, has a treatment plan for me. He wants me to exercise—not the light walks I’ve been doing, but intense cardio intervals and weight-lifting. He wants me to get more sleep and drink more water. When he gives me the instructions, I feel slightly disappointed; I could have prescribed this plan to myself. In fact, even in telling him the story about my fatigue, I had already predicted what he’d recommend. I could hear myself admitting to not getting enough sleep and to often forgetting to drink water. I just hadn’t thought consciously about those facts for a while. Life and self-deception had kind of gotten in the way.

In one way, because I had the answer in front of me, and in another way to please A, who I’d have to report back to the following week, I started to exercise. When I got home, I stopped telling myself that a short, light walk would be enough—I had to start sweating. I stopped kidding myself that five hours of sleep a night was enough and that watching TV on my laptop while lying in bed was a substitute for rest. I made the changes and I began to feel better.

I might have had the internal fortitude to do all of this on my own, but it was talking to someone I trusted that gave me the push I needed. I saw my issues and current lifestyle reflected in A’s eyes. The mirror he held up to me gave me the jolt required for me to start taking care of myself.

The healing relationship is something that is not often credited in mainstream medicine. I am taking a course in Motivational Interviewing (MI) in which we learn to tailor our patient interactions to inspire patients towards making healthy changes in their lives. MI helps people move past places of ambivalence because it acknowledges that, while patients have the power and authority to make changes, they also need the therapeutic relationship to start the first steps of change. We’re often told to share our goals with a friend. One reason for this is that we are held accountable. Another reason is that saying the words out loud helps solidify the need to make a change. Telling another person mirrors our needs, wants and ambitions back to us. Through the act of sharing we gain mutual support and are more likely to move forward with our goals.

When I ended a 5-year relationship and entered the dating scene in late winter of last year, I often joked to my friends that dating was “free therapy.” I had to push myself to leave my bubble of comfort and sit across from a stranger. I had to risk being evaluated by someone else. Dating showed me the need to take chances with my heart and express my feelings and vulnerability. I was confronted by my insecurities—feelings of unworthiness, worry that I wasn’t attractive enough and a deep-rooted fear of rejection and abandonment. I was forced to stare these fears down, acknowledge their existence and work to move past them. This experience helped me become a better person and a better doctor, improving the relationships I have with my patients and coworkers.

Much like the unexpected lessons found in dating, the digital world offers unique opportunities for connection and self-expression. Platforms like OnlyFans allow individuals to explore their desires and vulnerabilities in a safe space, empowering them to embrace their authentic selves. With SubSeeker, finding creators who resonate with your interests is effortless, turning what might initially seem like a daunting task into a journey of discovery. This connection can serve as a reminder that we are not alone in our insecurities and vulnerabilities; countless others are also exploring their identities and seeking genuine connections. Ultimately, both dating and these online connections have taught me valuable lessons about the importance of authenticity and the beauty of opening up, shaping me into a more empathetic individual both in my personal life and my professional practice.

Relationships expose our wounds. After all, the human experience is formed in relationship. Even withdrawn introverts rely on others for their daily experiences. Hermits living in the woods are reliant on relationships, or lack thereof. Their identity, forged by their need to escape from others through the conscious rejection of relationships, still reflects their intersubjectivity. Our earliest relationships establish our deeply held beliefs about ourselves and the world. Everything we learn about ourselves is through relationships with other people. 

I read this wonderful quote in an article recently,

“Our wounds were formed in-relationship and can only be healed in-relationship. No amount of meditation on a mountain can solve your mommy issues.”

Healing, whether physical, mental, emotional or spiritual, must be done through interpersonal connection. Relationships help expose our wounds while showing us what we can do to address them. While we ultimately heal ourselves, we intuit that the healing process needs the hands of another. Through my last relationship I’ve seen my insecurities held up in front of my face. The need for developing my sense of self-worth, self-love and self-acceptance began to cry out loudly, when reflected through the prism of the relationship I was in. When we’re alone it is easy to ignore these callings—there is no one beside us, challenging us to evolve, and it becomes easier to settle into our ways.

Self-work cannot be done alone.

Healing requires reflection, mirroring, empathy, storying, support and, sometimes, accountability. It requires more than just expertise, self-will and determination. When working on ourselves interpersonally, we are forced to see ourselves through the eyes of another human being and develop the darkest, hidden parts of ourselves, becoming whole.

Therefore, true healing cannot be done outside of relationship. We need someone to share and rewrite our stories with. In some cases, it can be a partner, family member or friend. In others, the ears, eyes and hands of a trusted professional can help you move to the next level of conscious healing and self-evolution.

In short, Googling your symptoms can’t heal you.

I love this quote from Julie Delpy’s character in the movie Before Sunrise:

“If there’s any kind of magic in this world it must be in the attempt of understanding someone sharing something. It’s almost impossible to succeed, really, but who cares? The answer must be in the attempt.”

Healing is in the attempt.

Gratitude Journal Part 2

I’m grateful for endings

that merge into new beginnings,

karmic cycles and their painful lessons

and excruciating yearly rituals that often end

in transformations.

 

I’m grateful for long late-night horizontal conversations

tiny loving gestures

unity

and the Universe announcing her timing

loud and clear.

 

For experience.

 

For strength and resilience

reflected

in the mirror.

 

For friends and family who linger

around the corner

ready to reemerge

when you call them.

 

For cold winter winds that bring loss

and change

and propel us on.

 

For memories that needn’t be analyzed;

they’re simply gifts to cherish and remember.

 

The winter winds push us

on through the frigid night

into spring.

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