On Thursday, June 20th, the Ontario government passed Bill C-59, exempting psychotherapy sessions from HST.
This is excellent news! This means that from now on, HST does not need to be charged for therapy visits (it was removed from Naturopathic Medicine appointments several years ago).
This makes therapy a little cheaper, as savings are passed onto you.
As many of you know, I have been a registered psychotherapist (qualifying) since the Summer of 2023 and have been accepting new clients since April 2024.
Sessions are covered by extended health benefits and are conducted online for Ontario and Quebec residents.
To learn more about working with me, feel free to book a 20-minute free meet and greet at taliand.janeapp.com
Therapy discussions involve:
burnout and stress
self-care
self-esteem, self-worth, self-talk
work stress and imposter syndrome
relationships
values and narrative therapy
grief
trauma
family systems, parental and intergenerational patterns, relational dynamics
cognitive behavioural tools
somatic and mindfulness tools
mental health care: dealing with depression, anxiety, ADHD symptoms, etc.
And so on.
I am an eclectic therapist who loves cognitive, psychodynamic, and humanistic approaches and therapy styles. I offer tools from various therapeutic modalities that might best suit clients and their needs.
I prefer not to rigidly adhere to one approach–you may choose to talk, prefer body-based tools, or want homework exercises or practical solutions to your problems. In the end, all therapy styles can be effective, but it comes down to the preferences and needs of the individual.
Therapy differs from naturopathic medicine appointments, which are more directive and prescriptive and involve bloodwork, supplements, herbs, and lifestyle recommendations.
In therapy sessions, we focus on building a nonjudgmental and supportive therapeutic relationship as we work on helping you gain self-understanding and insights to help you live by your goals and values.
Therapy and naturopathic medicine can pair well with one another.
Therapy can help remove obstacles to lifestyle changes, like self-talk or associations that can keep us feeling stuck. We can compassionately and non-judgementally explore factors that lower motivation or prevent us from taking the specific actions that we want.
Naturopathic medicine can support therapy by identifying the physical root causes of mental health symptoms and supporting the body through gut health, hormonal balance, and optimizing organs like the liver, blood sugar, stress response, and sleep.
They complement one another very well, and I often work with the same individual in both practices.
What does “Qualifying” after my registered psychotherapist title mean?
Therapists licensed by the College of Registered Psychotherapists of Ontario (CRPO) must put “qualifying” after their names until they have completed all three requirements.
450 hours of client session
100 hours supervision
completion of a Registration Exam
While psychotherapists qualify, they are still licensed, have a licence number, have sessions covered under insurance, and receive regular (weekly) supervision with a licensed supervisor.
Qualifying registrants typically have lower fees than psychotherapists who have completed these requirements.
My last step will be to complete the registration exam in Spring 2025, in which I expect to remove my title’s “qualifying” aspect.
Let me know if you have any questions about the registration and licensing of psychotherapists in Ontario!
“There’s a sunrise and a sunset every day and you can choose to be there or not. “You can put yourself in the way of beauty.” – Cheryl Strayed, Wild Yellow and orange hues stimulate melatonin production, aiding sleep. Melatonin is not just our sleep hormone, it’s an antioxidant and has been studied for its positive mood, hormonal, immune, anti-cancer, and digestive system effects. Our bodies have adjusted to respond to the light from 3 billion sunsets. While we can take melatonin in supplement form, use blue light blocking glasses, or use red hued light filters and, while tech can certainly help us live more healthfully, it’s important to remember that the best bio-hack is simply to remember your heritage and put yourself back in nature’s way. The best tech of all is in the natural rhythms of the planet and encoded in your beautiful DNA. Optimal health is about re-wilding. Optimal health is about remembering who you are and coming back to your true nature. You have the code within in you to live your best, healthiest life. I believe healing is about tapping into that code, supporting our nature, and allowing the light of our optimal health template to shine through.
The proximity to water can improve focus, creativity, health and professional success according to marine biologist and surfer Wallace J. Nichols in his book, Blue Mind. A “blue mind” describes a neurological state of of calm centredness. Being around water heightens involuntary attention, where external stimuli capture our attention, generating a mind that is open, and expansive, and neurochemicals like dopamine and serotonin are released. He says, “This is flow state, where we lose track of time, nothing else seems to matter, and we truly seem alive and at our best”. Contrast a blue mind to a red mind, where neurons release stress chemicals like norepinephrine, cortisol in response to stress, anxiety and fear. From the book Mindfulness and Surfing:
“Surfing is not just about riding a wave, but immersion in nature: the aching silence of a calm sea is punctuated by a cluster of blue lines. The point is to spend a little more time looking and listening than doing.
“Maybe this is not just about being but about what the philosopher Heidegger called “becoming”–a being in time, an unfolding sense of what he further called ‘dwelling’.
“When we dwell, we inhabit.”
Jungian Psychoanalyst, Frances Weller posed the question, “What calls you so fully into the world other than beauty?” In other words, “Without beauty what is it that attracts us into life?” Our human affinity for beauty is perhaps the greatest pull of all into aliveness. And yet so many of us feel purposeless, or that life is meaningless. In our world we are suffering from a “Meaning Crisis”, which perhaps partially explains the epidemic of mental health issues that plague us. We spend so much time bogged down in the business of being alive: bills, chores, work–“dotting Ts and crossing Is” as I like say 😂 This is part of the reason why 1/6th of my 6-week Mental Health Foundations program (Good Mood Foundations) involves getting into nature. For there is nothing more beautiful than the gorgeous imperfection of the natural world. We are called by it. There are myriad scientific studies on the power of “Forest Bathing” for de-stressing, for mental health, for supporting our mood, hormonal health, immune systems, social relationships, and so on. And yet so often when we say words like “beauty” we call on images of “perfection”: symmetrical youthful faces, bodies with zero fat on them, etc.
We are focused on the missing parts instead of how the effect of nature’s imperfect beauty has on us–and thus we rob ourselves of the pleasure of being in the presence of beauty. For what is pleasure but beauty personified? And what is depression other than a lack of deep, embodied soulful pleasure? I find being in nature brings me closer, not so much to beauty as a concept of commercial idealism, but a sense of pleasure. It pulls me into my body.
I feel my feet on the ground, my breath timing my steps, the birdsong and wind in my ears, and I feel calmed, and centred, called into the experience of being fully alive.
If you’re struggling to find meaning, practice showing up to your sunsets for a few evenings in a row.
Put yourself in the way of beauty. When the sunsets show up everyday, will you show up too?
It was a crappy week and I was chatting with a friend online. He said something that triggered me… it just hit some sort of nerve. I backed away from my computer, feeling heavy. I went to the kitchen to pour myself a glass of water and collapsed, elbows on the counter, head in my hands, my body shaking and wracking with deep, guttural sobs.
A few seconds later, I’m not sure how long exactly, I stood up. Tears and snot streaming down my face, I wiped them off with a tissue. I felt lighter, clearer. I was still heavy and sad, but there was a part of me that had opened. I went back to my computer and relayed some of this to my friend, “what you said triggered me, but it’s ok, it just hit a personal nerve. I’m ok now though, I know you didn’t mean any harm”. I typed to him.
Joan Rosenberg, PhD in her book 90 Seconds to a Life You Love, would have said that, in that moment, I had been open to feeling the moment-to-moment experience of my emotions and bodily sensations. I felt the waves of emotions run through my body, and let them flow for a total of up to 90 seconds. And, in so welcoming that experience and allowing it to happen rather than blocking it, fighting it, projecting it (onto my friend or others), I was able to release it and let it go.
For many of us, avoidance is our number one strategy when it comes to our emotions. We don’t like to feel uncomfortable. We don’t like unpleasant sensations, thoughts and feelings and, most of all, we don’t like feeling out of control. Emotions can be painful. In order to avoid these unpleasant experiences, we distract ourselves. We try to numb our bodies and minds to prevent these waves of emotion and bodily sensation from welling up inside of us. We cut ourselves off.
The problem, however is that we can’t just cut off one half of our emotional experience. When we cut off from the negative emotions, we dampen the positive ones as well.
This can result in something that Dr. Rosenberg titles, “soulful depression”, the result of being disconnected from your own personal experience, which includes your thoughts, emotions and body sensations.
Soulful depression is characterized by an internal numbness, or a feeling of emptiness. Over time it can transform into isolation, alienation and hopelessness–perhaps true depression.
Anxiety in many ways is a result of cutting ourselves off from emotional experience as well. It is a coping mechanism: a way that we distract ourselves from the unpleasant emotions we try to disconnect from.
When we worry or feel anxious our experience is often very mental. We might articulate that we are worried about a specific outcome. However, it’s not so much the outcome we are worried about but a fear and desire to avoid the unpleasant emotions that might result from the undesired outcome–the thing we are worrying about. In a sense, anxiety is a way that we distract from the experience of our emotions, and transmute them into more superficial thoughts or worries.
When you are feeling anxious, what are you really feeling?
Dr. Rosenberg writes that there are eight unpleasant feelings:
sadness
shame
helplessness
anger
embarrassment
disappointment
frustration
vulnerability
Often when we are feeling anxious we are actually feeling vulnerable, which is an awareness that we can get hurt (and often requires a willingness to put ourselves out there, despite this very real possibility).
When we are able to stay open to, identify and allow these emotions to come through us, Dr. Rosenberg assures us that we will be able to develop confidence, resilience, and a feeling of emotional strength. We will be more likely to speak to our truth, combat procrastination, and bypass negative self-talk.
She writes, “Your sense of feeling capable in the world is directly tied to your ability to experience and move through the eight difficult feelings”.
Like surfing a big wave, when we ride the waves of the eight difficult emotions we realize that we can handle anything, as the rivers of life are more able to flow through us and we feel more present to our experience: both negative and positive.
One of the important skills involved in “riding the waves” of difficult feelings is to learn to tolerate the body sensations that they produce. For many people, these sensations will feel very intense–especially if you haven’t practice turning towards them, but the important thing to remember is that they will eventually subside, in the majority of cases in under 90 seconds.
Therefore, the key is to stay open to the flow of the energy from these emotions and body sensations, breathe through them and watch them crescendo and dissipate.
This idea reminds me of the poem by Rumi, The Guest House:
This being human is a guest house. Every morning a new arrival.
A joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor.
Welcome and entertain them all! Even if they’re a crowd of sorrows, who violently sweep your house empty of its furniture, still, treat each guest honorably. He may be clearing you out for some new delight.
The dark thought, the shame, the malice, meet them at the door laughing, and invite them in.
Be grateful for whoever comes, because each has been sent as a guide from beyond.
One of the reasons I was so drawn to Dr. Rosenberg’s book is this idea of the emotional waves lasting no more than 90 seconds. We are so daunted by these waves because they require our surrender. It is very difficult however, if you suffer from anxiety to let go of control. To gives these emotional waves a timeframe can help us stick it out. 90 seconds is the length of a short song! We can tolerate almost anything for 90 seconds. I found this knowledge provided me with a sense of freedom.
The 90 seconds thing comes from Dr. Jill Bolt Taylor who wrote the famous book My Stroke of Insight (watch her amazing Ted Talk by the same name). When an emotion is triggered, she states, chemicals from the brain are released into the bloodstream and surge through the body, causing body sensations.
Much like a wave washing through us, the initial sensation is a rush of the chemicals that flood our tissues, followed by a flush as they leave. The rush can occur as blushing, heat, heaviness, tingling, is over within 90 seconds after which the chemicals have completely been flushed out of the bloodstream.
Dr. Rosenberg created a method she calls the “Rosenberg Reset”, which involves three steps:
Stay aware of your moment-to-moment experience. Fully feel your feelings, thoughts, bodily sensations. Choose to be aware of and not avoid your experience.
Experience and move through the eight difficult feelings when they occur. These are: sadness, shame, helplessness, anger, embarrassment, disappointment, frustration, vulnerability.
Ride one or more 90 second waves of bodily sensations that these emotions produce.
Many therapeutic techniques such as mindfulness, Dialectical Behaviour Therapy, somatic therapy, and so on utilize these principles. When we expand our window of tolerance and remain open to our physical and emotional experience we allow energy to move through us more gracefully. We move through our stuckness.
Oftentimes though, we can get stuck underwater, or hung up on the crest of a wave. Rumination and high levels of cortisol, our stress hormone can prolong the waves of unpleasant emotion. We may be more susceptible to this if we have a narrow window of tolerance due to trauma.
However, many of us can get stuck in the mind, and when we ruminate on an emotionally triggering memory over and over again, perhaps in an effort to solve it or to make sense of it, we continue to activate the chemicals in our body that produce the emotional sensation.
Therefore, it’s the mind that can keep us stuck, not the emotions themselves. Harsh self-criticism can also cause feelings to linger.
I have found that stories and memories, grief, terror and rage can become stuck in our bodies. Books like The Body Keeps the Score speak to this–when we block the waves, or when the waves are too big we can build up walls around them. We compartmentalize them, we shut them away and these little 90 second waves start to build up, creating energetic and emotional blockages.
In Vipassana they were referred to as sankharas, heaps of clinging from mental activity and formations that eventually solidify and get lodged in the physical body, but can be transformed and healed.
Perhaps this is why a lot of trauma work involves large emotional purges. Breathwork, plant medicines such as Ayahuasca, and other energetic healing modalities often encourage a type of purging to clear this “sludge” that tends to accumulate in our bodies.
My friend was commenting on the idea that her daughter, about two years old, rarely gets sick. “She’ll have random vomiting spells,” my friend remarked, “and then, when she’s finished, she recovers and plays again”.
“It reminds me of a mini Ayahuasca ceremony”, I remarked, jokingly, “maybe babies are always in some sort of Ayahuasca ceremony.”
This ability to cry, to purge, to excrete from the body is likely key to emotional healing. I was listening to a guest on the Aubrey Marcus podcast, Blu, describe this: when a story gets stuck in a person it often requires love and a permission to move it, so that it may be purged and released.
Fevers, food poisoning, deep fitful spells of sobbing may all be important for clearing up the backlog of old emotional baggage and sludge so that we can free up our bodies to ride these 90 second emotional waves in our moment-to-moment experience.
Grief is one of these primary sources of sludge in my opinion. Perhaps because we live in a culture that doesn’t quite know how to handle grief–that time-stamps it, limits it, compartmentalizes it, commercializes it, and medicates it–many of us suffer from an accumulation of suppressed grief sankharas that has become lodged in our bodies.
Frances Weller puts it this way,
“Depression isn’t depression, it’s oppression–the accumulated weight of decades of untouched losses that have turned into sediment, an oppressive weight on the soul. Processing loss is how the majority of therapies work, by touching sorrow upon sorry that was never honoured or given it’s rightful attention.”
Like a suppressed bowel movement, feelings can be covered up, distracted from. However, when we start to turn our attention to them we might find ourselves running to the nearest restroom. Perhaps in these moments it’s important to get in touch with someone to work with, a shaman of sorts, or a spiritual doula, someone who can help you process these large surges of energy that your body is asking you to purge.
However, it is possible to set our dial to physiological neutral to, with courage turn towards our experience, our emotions and body sensations. And to know that we can surf them, and even if we wipe out from time to time, we might end up coming out the other side, kicking out, as Rumi says, “laughing”.
The only way out is through.
As Jon Kabat Zinn says, “you can’t stop the waves, but you can learn to surf”.
About a month ago I fractured my right 5th metatarsal (an avulsion fracture, aka “The Dancer’s Fracture” or a “Pseudo-Jones Fracture”).
As soon as I laid eyes on the x-ray and the ER doctor declared, “Ms. Marcheggiani,” (actually, it’s doctor, but ok) “you broke your foot!” things changed.
I have never broken anything before, but if you have you know what it’s like. In a matter of seconds I couldn’t drive. I could barely put weight on it. I was given an Aircast boot to hobble around in, and told to ice and use anti-inflammatories sparingly. My activities: surfing, skateboarding, yoga, even my daily walks, came to a startling halt.
I spent the first few days on the couch, my foot alternating between being elevated in the boot and immersed in an ice bath. I took a tincture with herbs like Solomon’s Seal, mullein, comfrey, and boneset to help heal the bone faster. I was adding about 6 tbs of collagen to oats in the morning. I was taking a bone supplement with microcrystalline hydroxyapatite, pellets of homeopathic symphytum, zinc, and vitamin D.
We call this “treatment stacking”: throwing everything but the kitchen sink at something to give the body as many resources as possible that it may use to heal.
My brother’s wedding came and went. I was the emcee, and the best man. I bedazzled my boot and hobbled around during set-up, photos, presentations, and even tried shaking and shimmying, one-legged on the dance floor. The next few days I sat on the couch with my leg up.
I watched the Olympics and skateboarding videos. I read The Master and the Margarita and Infinite Jest. I got back into painting and created some pen drawings, trying to keep my mind busy.
I slept long hours–an amount that I would have previously assumed to be incapable. The sleep felt necessary and healing. I was taking melatonin to deepen it further.
I closed down social media apps on my phone to deal with the immense FOMO and stop mindlessly scrolling. I journaled instead, turning my focus from the outside world to my inner one.
It was a painful process, and not necessarily physically.
I was confined to my immediate surroundings–not able to walk far or drive. I was at the mercy of friends and family to help me grocery shop. The last year and a half has made many of us grow accustomed to social isolation and a lot of my social routines from years prior had fallen by the wayside.
My world, like the worlds of many, had gotten smaller over the last 18 months. With a broken foot, my world shrunk even further.
The loneliness was excruciating.
It would come in waves.
One moment I would relish the time spent idle and unproductive. The next I would be left stranded by my dopamine receptors, aimless, sobbing, grieving something… anything… from my previous life. And perhaps not just the life I had enjoyed pre-broken foot, but maybe a life before society had “broken”, or even before my heart had.
I thought I would be more mentally productive and buckle down on work projects but it became painfully obvious that my mental health and general productivity are tightly linked to my activity levels. And so I spent a lot of the weeks letting my bone heal in a state of waiting energy.
My best friend left me a voicemail that said, “Yes… you’re in that waiting energy. But, you know, something will come out of it. Don’t be hard on yourself. Try to enjoy things… watch George Carlin…”
During the moments where I feel completely useless and unproductive, waiting for life to begin, I was reminded of this quote by Cheryl Strayed. This quote speaks to me through the blurry, grey haze of boredom and the existential urgency of wasting time.
It says,
“The useless days will add up to something. The shitty waitressing jobs. The hours writing in your journal. The long meandering walks. The hours reading poetry and story collections and novels and dead people’s diaries and wondering about sex and God and whether you should shave under your arms or not. These things are your becoming.”
These things are your becoming.
Something will come out of it.
When I did a 10-Day Vipassana (silent meditation) retreat in the summer of 2018, I learned about pain.
It was Day 3 or 4 and we had been instructed to sit for an entire hour without moving. The pain was excruciating. The resistance was intense. I was at war with myself and then, when the gong went off and there was nothing to push against, I noticed a complete relief of tension. I was fine.
The next time I sat to meditate (another hour after a 10 minute break), I observed the resistance and released it. It’s hard to describe exactly what I did. It was something like, letting the sensations of pain flow through me like leaves on a river, rather than trying to cup my hands around them, or understand or making meaning out of them.
The sensations ebbed and flowed. Some might have been called “unpleasant” but I wasn’t in a space to judge them while I was just a casual observer, watching them flow by. They just were.
And when I have intense feelings of loneliness, boredom or heart-break I try to remember the experience I had with pain and discomfort on my meditation cushion. I try to allow them.
“This too shall pass”.
When I have a craving to jump off my couch and surf, or an intense restlessness in the rest of my body, the parts that aren’t broken, I try to let those sensations move through me.
I notice how my foot feels. How while apparently still, beneath my external flesh my body is busy: it’s in a process. It’s becoming something different than it was before. It’s becoming more than a foot that is unbroken. It’s becoming callused and perhaps stronger.
Maybe my spirit is in such a process as well.
The antidote to boredom and loneliness very often is a process of letting them move through, of observing the sensations and stepped back, out of the river to watch them flow by. A patience. Letting go.
I can’t surf today. But, it is the nature of waves that there will always be more.
Pima Chodron in her book When Things Fall Apart also references physical pain and restless in meditation while speaking of loneliness.
She writes,
“Usually we regard loneliness as the enemy. Heartache is not something we choose to invite in. It’s restless and pregnant and hot with desire to escape and find something or someone to keep us company. When we can rest in the middle, we begin to have a nonthreatening relationship with loneliness, a relaxing and cooling loneliness that completely turns our usual fearful patterns upside down.”
She continues,
“When you wake up in the morning and out of nowhere comes the heartache of alienation and loneliness, could you use that as a golden opportunity? Rather than persecuting yourself or feeling that something terribly wrong is happening, right there in the moment of sadness and longing, could you relax and touch the limitless space of the human heart?
“The next time you get a chance, experiment with this.”
“The problem with depression is, you can’t see the end.”
Depression is like a ditch. Sometimes you head into and get stuck, but you manage to wiggle out. Other times you’re in a major rut and can’t get out at all. In those cases you need to call someone. It happened to me once. I was driving in the winter to a hiking spot and I thought that a flat-looking patch of snow was the side of the road and before you know it I’d driven into a ditch. I couldn’t get out. I tried gunning it, putting rocks under my tires, getting a friend to push. Eventually I just had to call someone. Within a few minutes, a tow truck came. The man driving it unceremoniously and unemotionally told me to put the car in neutral. He hooked a giant chain to my bumper. He yanked me out of the ditch. And then he drove off. Roadside assistance. In my last post I said something akin to “health is not emotional”. It’s sometimes just an equation. With patients I educate them on their prefrontal cortex, on brain inflammation, on Polyvagal Theory and the nervous system and how depression is a normal response of the nervous system to abnormal circumstances, and how to they can work with their body and environment to get the help they need to yank them out of the ditch. But I also talk about the people around us. We need them. We need them to be our prefrontal cortexes (because when you’re depressed or anxious yours isn’t working at full capacity–you CAN’T just yank yourself out a ditch, you need a tow truck, a chain and an unceremonious dude who knows what to do). You need a strategy. You need a hand. You need help.
Just like getting out of a ditch requires outside help, navigating depression and mental health challenges often means reaching out to someone who knows how to guide you through. It’s not a weakness—it’s a recognition that sometimes you need a strategy, a hand, and a steady presence to help you find your footing. That’s where Hebert Counseling comes in. With experienced professionals who understand the complexities of mental health, they provide the kind of support that helps you reconnect with yourself and your environment.
Therapy isn’t about being told what to do—it’s about working with someone who understands the underlying patterns and can help you create a plan to move forward. Depression can make even the simplest tasks feel insurmountable, but having someone to listen, validate your experience, and help you develop tools to regulate your nervous system makes all the difference.
Depression often feels like an insurmountable barrier, making it hard to see beyond the immediate struggles. It’s essential to recognize that this condition is not a personal failing but a natural response of the nervous system to overwhelming circumstances.
By understanding the interplay between brain inflammation, the prefrontal cortex, and the nervous system through frameworks like Polyvagal Theory, patients can gain insights into their experiences and find ways to support their mental health effectively. This knowledge can empower individuals to take proactive steps, but it’s also crucial to remember that overcoming depression frequently requires external support.
In this context, resources like Avesta Ketamine Wellness offer valuable assistance. Their approach integrates cutting-edge treatments with a supportive environment, providing a crucial lifeline for those in need. Just as a tow truck and a skilled driver are essential for getting out of a ditch, having access to professional help and a comprehensive treatment plan can make all the difference in navigating the complexities of depression.
With the right support and strategy, individuals can find their way through challenging times and work towards regaining their mental well-being. Who’s your support team? Who are the people around you?
I talk to my patients about bringing their loves ones on board to help them set up systems to regulate their nervous systems, nourish their brains and bodies (don’t even think for a second that I didn’t have a snack to munch on while waiting for the two truck–this fact is not even metaphorical. You NEED a literal snack to fuel your brain), and reduce inflammation.
There is a theory of depression that it is an ADAPTIVE state meant to get us through a difficult time.
Famine. Capture by a predator. Infection or illness. Isolation from the group.
These may have been the historical hunter-gatherer inputs that caused depression but now it seems that depression can be triggered anytime our bodies are in a perceived or real “stuck” state with no way out.
Many, if not most, or all, depressive episodes I’ve worked with follow a period of intense anxiety. Our body’s stress response burns out, we can no longer “get away from danger” and we shutdown and collapse.
We turn inwards. We immobilize. We ruminate (possibly as a way to THINK our way out of danger).
This is why the 2a serotonin receptors that encourage “active coping” or things like BDNF, which is involved in making new brain cells, have important roles in the treatment research for major depression.
I’ll bet you’ve been told you have a disease, though. Something incurable that you’ll deal with your whole life.
But what if, rather than a disease, depression is a STATE you visit, and sometimes get stuck in that follows anxiety, stress and certain triggers?
How might that change the way you see yourself and your mental health? How might that change the way you seek solutions to how you’re feeling?
“The Adaptive Rumination Hypothesis by Andrews and Thomson posits that depression is not a pathology but a set of useful complex thoughts and behaviours that enable troubled people to withdraw temporarily from the world, deliberate intensively about their social problems, and devise solutions.”
From the Psychiatric Times
The major problem with depression that keeps us stuck in the state is when we turn our rumination back on ourselves and engage in self criticism.
Is anyone else feeling wet dog in a bathtub-level lonely? With this pandemic loneliness is on the rise. And we already lived in an epidemic of loneliness. Humans are social creatures with attachment needs–and many of us are alone or surrounded by people who make us feel more alone. Sometimes loneliness doesn’t make sense.
This is a time when loneliness has turned from epidemic to global pandemic.
As we physically distance, the emotional distance between each other becomes greater.
I don’t have a solution to loneliness, but the great minds of neuroscience, psychology, literature, philosophy, and spirituality have written on it a great deal, and so I’m going to examine some of it in the following paragraphs.
1. “Saying Hello Again” When I first announced this project, many people reached out to me and talked about their grief: the loss of a spouse, a beloved pet.
Many more of us are grieving relationships with those who haven’t died, but who we don’t get to interact with as much anymore. Grief is a tricky subject. In our society we don’t have established rituals for grieving. In the DSM if you’ve lost a loved one more than two weeks ago, and your grief coincides with the symptoms for Major Depressive Disorder, you’re considered mentally ill.
Imagine losing someone important to you and not feeling depressed for more than two weeks…
In many instances we NEVER “get over” the pain of losing someone. And yet, in many ways, grief that interferes with our productivity and way of being is pathologized. Narrative Therapy invites us to grieve in ways that I have always felt were the richest and most helpful. It does this through a series of “Remembering Conversations”. (For more, I’ve linked to the paper “Saying Hello Again” by David Denborough.) You can speak remembering conversations out loud with a friend or therapist. You can write them down, or walk in the woods and reminisce. Find a quiet space where you can think of your loved one. It could be someone real, currently alive but not present–a religious figure, or a famous person. A stuffed animal. A pet. An ex-lover. Or someone who has passed away. Call them into your memory, and consider the questions. – What did [your loved one] see when they looked at you through loving eyes? – How did they know these things about you? – If they could be with you today, what would they say to you about the efforts you are making in your life? What words of encouragement would they offer? – What difference would it make to your relationships with others if you carried this knowledge with you in your daily life?
2. Feeling Lonely vs. Being Alone. “You come home, make some tea, sit down in your armchair, and all around there’s silence. Everyone decides for themselves whether that’s loneliness or freedom.” Surely solitude and loneliness are related but not equivalents. My patients and friends who are married with children crave alone time. My single friends who live alone crave company. What most of us want, however, is the feeling of freedom that comes with being ourselves. And we all know that this feeling can arise alone in the comfort of our own company or in the presence of those who fully accept us. The Dalai Lama has repeatedly claimed that he never gets lonely.
When he was asked the question “Do you get lonely?” at a speaking forum, it took the translator a while to convey the concept to him before he was able to answer. According to him, loneliness is not a condition of solitude. It’s a condition of mindset.
He weighs in: “We often are alone without feeling lonely and feel lonely when we are not alone, as when we are in a crowd of strangers or at a party of people we do not know. “Clearly the psychological experience of loneliness is quite different from the physical experience of being alone. “We can feel joy when we are alone but not when we are lonely… Much depends on your attitude. If you are filled with negative judgement and anger, then you will feel separate from other people. You will feel lonely. “But if you have an open heart and are filled with trust and friendship, even if you are physically alone, even living a hermit’s life, you will never feel lonely.” The loneliest I’ve felt is when I was in a relationship with someone whose love I couldn’t feel. But, I’ve felt completely at home and accompanied while traveling with strangers. When do you feel you can truly be as you are?
3. On being socially awkward and telling ourselves stories. We were in the midst of … isolation and so my friends cancelled their baby shower. They asked for books (if we were compelled to send gifts) and something else, I don’t remember…(clothes?) So I hopped on Amazon and happily ordered a few books I remember loving as a kid: Amos the sheep who doesn’t want to give up his wool, Frances the badger who gets conned into giving up her porcelain tea set in lieu of a plastic one, and so on. My friend is a therapist and I was sure he’d appreciate the psychotherapeutic subtext of these stories: finding self-worth, developing boundaries, etc. Anyways, I sent the books off and forgot about it. Then, one lonely evening I sat on the couch alone and let my Default Mode Network run rampant. I started ruminating on the books–they must have arrived. I hadn’t heard from my friends. Maybe they were going to send out more formal thank you card.
Or maybe something was wrong. Then I realized that they were about to have a BABY, a mere fetus+1 day. And I realized in horror I had sent them a pile of children’s books–for 3-5 year olds.
I felt out of touch, self-absorbed–I felt ashamed. And then I felt ashamed at my shame–surely this wasn’t such a big deal? What was wrong with me? I tried to Cognitive Behaviour Therapy my way out of this thought trap–this story about being weird and disconnected. I couldn’t do it. I eventually reached out to another friend who has two kids. She played the role of my prefrontal cortex (using others for emotional regulation is extremely helpful). She assured me that babies can’t read anyways and so, whatever, any kind of book is fine. Duh… then I realized: this is the collateral of isolation.
If the gifts had been unwrapped in person, I might have realized they were slightly age inappropriate and would have made a joke. People would have laughed, we would have moved on. Instead, my mind was free to fill the silent void with stories. Eventually I confessed my neuroticism to my friends, embarrassed. They laughed and thanked me for the gift. We tell ourselves stories about how others see us all the time. About their judgements and prejudices, motivations, anger, hostility and failings.
What story are you telling yourself about the people in your life?
4. The Power of Art. Remember this scene from the movie Good Will Hunting? Sean : [during a therapy session, after coming from the job interview with the NSA] Do you feel like you’re alone, Will? Will : [laughs] What? Sean : Do you have a soul mate? Will : Define that. Sean : Somebody who challenges you. Will : I have Chuckie. Sean : You know Chuck; he’s family. He’d lie down in fuckin’ traffic for you. No, I’m talking about someone who opens up things for you – touches your soul. Will : I got – I got… Sean : Who? Will : …I got plenty. Sean : Well, name them. Will : Shakespeare, Nietzsche, Frost, O’Connor, Pope, Locke… Sean : That’s great. They’re all dead. Will : Not to me they’re not.
This exchange has always come to mind when I think about the loneliness of trying to find a soulmate–someone who knows the secrets and truths that lie deep in our hearts. Do our soulmates need to be living people who we share our lives with? People we can converse with on a daily basis? Ideally yes. However, many people in literature will speak of the phenomenon about feeling alone in a crowded room, with no one to share their private thoughts. When we read someone’s deep thoughts and feelings and relate it… makes us feel less alone, especially if what we’re reading speaks directly to our own hearts. You know that sensation, when you’re feeling something really deeply and then you read or hear someone else (maybe someone you know, maybe someone famous, or dead) describe that phenomenon in a way that is far more eloquent and articulate than you feel you ever could?
That feeling of being deeply validated and understood. Literary soulmates. People who have thought long and hard about this particular existential human experience you’re going through right now.
Not only have they lived it, but they’ve taken the trouble to put it into words, images, music. To remind you that you’re sharing a nervous system with 8 billion other living human beings . To remind you that you’re not alone.
5. Making Friends as an Adult aka Going After What Lights You Up. “You can’t make friends in your 30s”.
My friend’s brother is an investment banker in Manhattan and this was his claim a few years ago. My friend, a bonafide hippie (they are hilarious opposites) and I wondered if it was true. I’ve spent pockets of my adult life wishing I had more friends. I’ve had long conversations with patients who wish they had more friends, or are looking to date and having trouble meeting people. One of the things I was grieving during the last few months was loss of the spontaneity of meeting people.
No more picnics on the Island where a random group of people invite me to share their wine and then write letters to my Nonna.
No more “networking” events I decide at the last minute to drop in on, where I meet a friend who introduces me to someone who would soon be a best friend. No more of that randomness. A contraction of possibilities. The same friend wrote to me, in an email we sent to each other in our early 20s when we were out of school and trying to find our way. “I don’t even know what it is about making friends. It can just be so random the way you meet someone in passing you might really connect [with] or you might ignore each other after 5 minutes and never speak again.
“The philosophy is right — if you go after what lights you up you are bound to stumble upon someone else who is lit on that in their own way and for their own reasons so you are bound to connect on some level!” And, of course we’ve heard this so many times: go after what you’re passionate about and the people will trickle in, like a kind of osmotic current. And it’s easier said that done, finding out what lights you up. I suppose it starts with creating an open question and waiting for the answer to show itself. Lake surfing was one of the answers that manifested itself to me. It’s been a blessing for me in so many ways–from even finding out it existed, to randomly meeting people in the line-up to my regular surf buddies, to the photographers who celebrate us on social media, the sport, although technically a solo one, is all about connectivity. Water is sticky. so are we.
6. Self-Soothing. Will scientists and drug companies create a pill for loneliness? Hormones like oxytocin, endogenous opioids (our body’s own morphine) and allo-pregnenalone, a steroid hormone related to estrogen, progesterone, testosterone, and cortisol, are all common targets for “medicating” loneliness. We can medicate loneliness ourselves, however through self-soothing. Self-soothing behaviours include: – talking about your emotions with others – social and physical warmth (getting cozy and Hygge) – Touching, including self touch and self holds – Soothing music – Satiety through consuming high-calorie foods (chocolate, anyone?) – And even drugs, although engaging in the above self-soothing behaviours tends to protect against drug addiction in the research–if you’re able to reach for a cozy sweater and a puppy in order to self-soothe you’re probably less likely to turn to alcohol. Self-soothing behaviours increase oxytocin in the brain. They calm areas of the brain like the insula and amygdala that are associated with anxiety. Self-soothing boosts endogenous opioids (research shows that opioids like morphine help calm the sting of social rejection, which our brain perceives to be the same as physical pain), and serotonin and dopamine. Self-touch or self-holds is an excellent way to self-soothe. In my podcast on Polyvagal Theory with Dr. Steph Cordes, we talk about self-touch: things like putting a hand on your chest, wrapping your arms around yourself, child’s pose, or cupping your face in your hand. Sometimes speaking your own emotions can be helpful (“I feel sad right now” or “This is hard”). Also, particularly where these emotions pertain to loneliness, invoking a common humanity can he a helpful tool for feeling less alone and can help soothe and process hard feelings. “Everyone feels this way sometimes”, or “Suffering is a part of life”. In Mindful Self-Compassion, invoking a common humanity is an important step in taking the burden of our feelings off of ourselves and recognizing that we’re all interconnected in the emotional space. How do you self-soothe?
7. Attunement. “[Attuning with others] is at the heart of the important sense of “feeling felt” that emerges in close relationships. “Children need attunement to feel secure and to develop well, and throughout our lives we need attunement to feel close and connected.” – Dan Siegel, MD Attunement is the process of responding to another’s emotional cues. Infants first learn attunement from their parents. When a parent can read a baby’s expressions or hear her cries and respond appropriately: with comfort, food, warmth, a diaper change, it builds a sense of trust in the infant’s body. The baby feels seen and understood by the world. A lack of attunement can cause attachment insecurity: leading to feelings of anxiety, distrust, emotional avoidance, depression, and relationship dissatisfaction. It’s ultimately lack of attunement that results in mental health challenges in an adult’s life. Attuning to others can be hard if you didn’t receive the proper attunement from your parents. However, we can still learn to attune to ourselves and others as adults.
Here are some tips for learning how to be more attuned: – Attune to yourself first: starting by recognizing what you feel in your body: what thoughts, emotions and feelings are present? How are you breathing? – Practicing mindfulness can help you understand what is going on in your body and mind, as you learn to attune to yourself emotionally. – When trying to attune to another, limit distractions (turning off the TV, putting away cellphones, etc.) so that you can fully pay attention to the emotional space. – Make eye contact and mirror the others’ physical cues: mimic their postures, gestures and even tone of voice. Physical mirroring is a hallmark skill of attunement. – Listen carefully with compassionate curiosity: seek to understand before seeking to be understood (a useful cliche). Can you give the other person the benefit of the doubt? Can you try your best to relate to what they might be staying and hold them in what Carl Rogers called “Unconditional Positive Regard”? – Can you try to identify what emotions someone might be experiencing as you talk to or sit with them? What are you feeling in your own body?
8. Sharing the Things that Matter “Loneliness isn’t the physical absence of other people – it’s the sense that you’re not sharing anything that matters with anyone else.”
— Johann Hari, from his book Lost Connections. Johann also writes: “Be you. Be yourself… “We say it to encourage people when they are lost, or down. Even our shampoo bottles tell us—because you’re worth it. But what I was being taught is—if you want to stop being depressed, don’t be you. Don’t be yourself. Don’t fixate on how you’re worth it. It’s thinking about you, you, you that’s helped to make you feel so lousy. Don’t be you. “Be us. Be we. Be part of the group. Make the group worth it. “The real path to happiness, they were telling me, comes from dismantling our ego walls—from letting yourself flow into other people’s stories and letting their stories flow into yours; from pooling your identity, from realizing that you were never you—alone, heroic, sad—all along. “No, don’t be you. Be connected with everyone around you. Be part of the whole. Don’t strive to be the guy addressing the crowd. Strive to be the crowd. So part of overcoming our depression and anxiety—the first step, and one of the most crucial—is coming together.” And, “Now, when I feel myself starting to slide down, I don’t do something for myself—I try to do something for someone else. I go to see a friend and try to focus very hard on how they are feeling and making them feel better. “I try to do something for my network, or my group—or even try to help strangers who look distressed. “I learned something I wouldn’t have thought was possible at the start. Even if you are in pain, you can almost always make someone else feel a little bit better. Or I would try to channel it into more overt political actions, to make the society better. When I applied this technique, I realized that it often—though not always—stopped the slide downward. It worked much more effectively than trying to build myself up alone.” I think what Johann is saying is that a sense of meaning, purpose, belonging can’t coexist with loneliness.
Psychoanalyst Francis Weller says it another way,
“at some point we have to stop being the one looking for homecoming and be the one offering it.
“As long as I identify as the homeless child who didn’t get welcomed back I need to make a pivot and say ‘I can also, because of that wound find the medicine of welcome’.”
In what way does being of service help you feel more connected?
How have you learned to deliver what Francis calls “the medicine of welcome” to others?
9. Needs are the doorway to the Inner Child, Imagination, Desire and Purpose. James Hillman, the great Jungian psychoanalyst urges us to use our needs–loneliness being one–to explore the depths of our soul. Loneliness, according to Hillman is, like any other need, “a voice that demands to be satisfied”.
We believe that loneliness represents a void that can be filled by something external: a person’s physical presence, or the actions or words of another that fills the space inside. But a need is actually a doorway: to the Inner Child, who opens the door to the imagination. The need represents something much more, not just love but a kind of archetypal, “divine” love. Not just company, but the deep longing to be whole, to unite with “the beyond”. When we feel needy, or lonely, our Inner Child, according to the Jungians, is crying out. It doesn’t just want to complain.
Hillman says, “The intensity of the need reflects the immensity of the world beyond from which it comes.” The child can help us imagine–when we articulate the need, speak it out loud and feel deeply into the body the sensations that that need creates (where do you feel the need? Where do you feel loneliness?), we let it come up fully. We turn towards the child. We can then be specific about the need. What are we fantasizing will fill this loneliness? Who do I want with me? What would they say? What would they do? Are we riding horses in the sunset?
Allowing the images to come.
Allowing the needs to become wants. When we stay with the loneliness long enough, this voice crying to be satisfied, until it becomes a want, something interesting happens. The emptiness of the need, the lack that represents loneliness begins to become filled: with wanting, with desire. The writer DH Lawrence tells us that “Desire is holy”. It is hot, fiery, passionate. It fills us: “I am filled with desire”. It motivates us. It makes things happen. Desire connects us with the beyond. It moves us towards our purpose.
According to Hillman, a fear of desire stands in the way of finding one’s purpose.
We are afraid of the Inner Child: the weakness that being needy represents.
We feel shameful at our weakness, at our neediness. We deny the needs, or try to fill them some other way. Or we criticize ourselves, punishing the child, or ignoring the child.
But what if this deep, existential loneliness, this longing to be united with what “lies beyond” or what lies deeply in our soul is really the doorway to purpose, to fire, to passion, to an integrated and complete psyche.
What if this neediness is not asking to be filled by external factors: parties, social media likes, validation, but with this deeply felt sense of desire that fuels us in the direction of our dreams?
What is the loneliness asking of you?
When you let the loneliness cry out, when you allow it to provide you with images, and when you allow the loneliness to become a want, what does it drive you to do?
What does it fill you with?
What does it inspire you to do next?
10. Getting To Know Yourself. “If you’re lonely when you’re alone, you’re in bad company.”
— Jean-Paul Sartre. Through this series we’ve explored the concept of feeling alone while surrounded by other people, and feeling utterly content while in complete solitude. And, so loneliness isn’t so much about being physically isolated, but in our deeper inner feelings of connection. The Stoics and the Buddhists tell us that, when we feel lonely it’s because we’ve stepped out of the present moment.
We’ve turned our thoughts to what we lack; we’ve identified with our suffering.
And, according to James Hillman and many other thought leaders on the psyche, we’ve decided that the solution to our suffering is located “out there”, in the external world. But no, say the Buddhists, Stoics and other philosophers. The solution to our suffering is internal. It lies within. And so, they say, when you’re lonely, you need to spend even more time alone–getting to know yourself. When we know ourselves, we feel relaxed in our own company. When we know ourselves, we can share ourselves with others when we’re blessed with their company, thus feeling more connected to them and less alone. Perhaps loneliness isn’t being isolated from others—not all the time.
Loneliness is the feeling we have when we’re isolated from our true selves. So, how can we get to know ourselves? The Buddhists say, sit.
Pay attention to your thoughts, your emotions and your body sensations in the present moment.
James Hillman tell us to watch our pain turn into desire, which tells us what the soul deeply wants. This time of year is hard for a lot of us. Add on a global pandemic, and this year is looking like a challenging one for most. Can you spend some quiet time alone with yourself?
Can you watch the feelings of loneliness arise and fall in your body? Can you deliver yourself a little self-compassion? In those private moments of emptiness, say: “Loneliness is here”. “Everybody feels this way sometimes”. “May I be kind to myself”. And, can you say:
She told me that lately, all the children she works with have a label. “Meredith can’t attend your online class because it’s her first day of school and she can’t handle more than two things because of her anxiety”, one mother wrote in an email as she backed out of a private class my friend had created by special request.
“Everyone is nervous on their first day of school”, my friend remarked, as she recounted the story to me.
“I need everyone’s microphones muted”, a 10-year old student exclaimed during an online class, “I have sensory overwhelm and attention deficit disorder and can’t handle background noise”.
My friend spent three years teaching in a rural school at the edge of a volcano in Guatemala. She worked in a private girls’ school in Colombia. And she taught grade 1 at an outdoor jungle school on the Pacific Coast of Mexico. “I’m not used to these North American kids”, she reflected.
“I wonder what diagnoses we’d have gotten in university?” I mused. I remember our Revolutionary Wall–pictures of Noam Chomsky, Victor Jara and Ghandi plastered on the wall that welcomed us into the entrance of our dirty apartment.
That year we’d worn our sweaters backward because it “felt right” to rest your chin on your hood, stopped washing our hair to “let the oils moisturize our roots”, and spent a week on a 1000-piece puzzle instead of going to class.
It was our last year. We were done.
My other friend was diagnosed with cancer, which would soon turn terminal. I was suffering from some sort of unacknowledged eating disorder–there were no body positivity Instagram feeds at the time. I could have used some.
It was a painful year.
For those and many more reasons, I’m sure, I was depressed.
I remember at some point during that year heading to a walk-in clinic because I was gaining weight, depressed, exhausted and completely shutdown. The walk-in clinic doctor told me “it wasn’t my thyroid” and to “eat less” so that I would lose weight.
I never got a diagnosis.
I was never offered an antidepressant.
I remember feeling hopeless. Desperate for an answer, but most of all, a solution.
If she had offered me an antidepressant, I’m certain I would have taken it. In fact, I did end up taking one about a year later for a brief period when living in Colombia (before the side effects made me stop).
I escaped a label.
My journey forked in the road and I took the one less traveled that led me towards naturopathic medicine.
Before that, though, I saw my own natural doctor who listened to me and put together the puzzle of my symptoms (who knew that skipping class to put together our 1000-piece puzzle would figuratively prepare me for my future career).
Rather than diagnose me, he listened to me and told me the underlying causes of my symptoms–not just what they were called.
And then, because we knew the cause, we also had a solution. And I soon felt better.
Of course, when I started naturopathic school, another 4-year full-time program with full days of classes (sometimes 10+ hours a day) and millions of exams and assignments, the underlying hormonal conditions that drove the original depressive episode I experienced at the end of my undergrad resurfaced.
I ended up seeing a fourth year naturopathic intern and she put me on something called adaptogens.
Adaptogens are class of plants. They support our Hypothalamic-Pituitary-Adrenal (HPA) response, which orchestrates the stress response. They are studied in rats who, when given adaptogens can perform longer on swim tests, producing less cortisol (our stress hormone) in the process.
These rats can tread water longer, without as much stress hormone and therefore, with less damage from stress. Depression is one of those side effects from the damage of psychosocial stress.
Stress leads to shutdown, inflammation and further hormonal imbalance, causing a wide variety of symptoms that seem disconnected but arise from the same source.
After all, isn’t depression, anxiety and burnout just us trying to keep our heads above water?
Oh man, did I ever wish I’d known about adaptogens in undergrad!
If I could have, I would have shouted about them from the rooftops, thrown bottles of them out of a plane, put them in the water supply.
I can’t do those things, but I can put many of my patients on them. Many of my patients suffering from depression and anxiety, caused by problems with their HPA axises, end up taking adaptogens.
I prescribe them when those I work with experience things like low mood, fatigue, sleep issues, inflammation (pain and swelling), hormone imbalances, particularly PMS or peri-menopause, sugar and salt cravings, delayed muscle recovery, tension, panic attacks and anxiety, dizziness and weakness, low motivation, and other oh-so-common symptoms often labelled as Major Depressive Disorder or other psychiatric illnesses.
Did I ever wish I’d known about adaptogens when I was in undergrad.
Instead I remember taking a crappy B vitamin complex from the local drugstore that a roommate’s mom gave me because I was on the birth control pill and “you need B vitamins on the birth control pill”. (Which is true: you need more vitamin B6 on the pill, but probably not one from a local drugstore multivitamin).
It didn’t do much.
I really really wish someone, a fairy godmother, the walk-in clinic physician, a man on the street, an article somewhere on the internet (like this one), had told me, “You have these symptoms because you are suffering from HPA axis dysfunction, as a result of significant psychosocial stress. This makes you suffer from the symptoms you’re dealing with, depression not being a condition of its own, but just another symptom of this condition.
“Adaptogenic herbs can help you get through this, as well as some important foundational lifestyle pieces that someone like a naturopathic doctor can help you with.
“There is a reason for your suffering. A context behind it. There is a cause we can identify.
“And, most importantly, there is a solution.”
But, I didn’t have anyone to tell me that.
I really wish someone had told me about adaptogens, but I haven’t ever wished that someone had diagnosed me with depression.
Now, a diagnosis can be extremely validating for some.
It can be lifesaving.
Medical intervention can also be really helpful for some people. But, like adaptogens (I should add), medications aren’t a one-size-fits-all solution.
We don’t know what causes depression and anxiety (likely many factors, HPA axis dysfunction being one of them), but we do know it’s not caused by a chemical brain imbalance.
And medications are designed to correct the brain imbalance that doesn’t exist, which is why they don’t work in everyone.
However, they do do something in some. Because, even though they don’t really solve the problem they’re supposed to (at least not in that simplistic way), they might be doing something else, which solves a problem in a few people.
The problem is, antidepressants make some people feel worse. In others they do nothing. And, in some of the people they do help, they don’t do enough. We’re still suffering.
And labels, while they can be helpful and lifesaving in some cases, can do damage in others.
Take my friend’s student with anxiety. What if her story of “I get stressed out on the first day of school because I have anxiety” turned into:
“I get stressed out on the first day of school because a lot of people do. It’s normal to feel nervous and anxious on the first day of school and want everything to go right.”
Now, of course, I don’t want to insinuate that anxiety isn’t a real thing. Of course it is!
There are many of us who suffer from anxiety disorders–a higher amount of anxiety than is common. Rather than first-day jitters, they might experience severe panic and complete dysfunction that make life miserable.
However, in the first example, the power is out of this student’s hands. It lies in her identity. In her dysfunction.
In her label.
In the second, it becomes a shared human experience, which she might be able to externalize and work with. Because it’s a common experience, she might find support, kinship, and understanding in those who experience the same.
Of course, I don’t know her case specifically. Maybe her diagnosis has helped her. Maybe her anxiety is well labelled and managed. Maybe she doesn’t need help. Maybe she is doing just fine.
All I know is, I wonder what I would have been diagnosed with, with my sweater on backwards, my hair full of grease, my body heavy like lead, a million puzzle pieces spewed all over the kitchen table in my dirty apartment with the revolutionary wall.
I have no idea what my diagnosis would have been, but I’m personally glad I never got one.
Instead, I wish I had had the permission to go through what I was going through.
I wish I’d had context for my suffering.
I wish I’d been given hope that things would get better.
I wish someone had empowered me through understanding the underlying causes of my symptoms and, of course,
I appeared on the Rebel Talk Podcast with Dr. Michelle Peris, ND. Dr. Michelle writes,
“Not a week goes by that I do not discuss mental health with patients in my office. Rates of depression and anxiety are on the rise. So I really wanted to unpack this important topic for you, giving you relevant information and diving deep into interventions that can help optimize mental health. ⠀
⠀
In this episode, Dr. Talia details how our brains work while suffering from depression, anxiety and stress. Her deep knowledge of neuroscience is combined with mindfulness practices and also with microdosing, an approach that consists in taking low doses of psychedelic drugs, such as LSD or psilocybin-containing “magic” mushrooms, in order to prevent and treat symptoms of depression. ⠀
⠀
Dr. Talia talks about mental and physical barriers, that can holds us back from making the changes needed for a healthier and more balanced life. Listen to this podcast and be inspired by this out-of-the-box conversation about neuroscience, mental health and mindfulness.”
I will never get annoyed at a patient’s “lack of compliance” again.
Health care is scary, even when you know what you’re doing. When it’s your own health, putting yourself in the hands of a professional is not easy.
Yesterday I had an initial consult for myself with a nutrition specialist. She’s well-known in her field, super-academic, in her 70s, and has published books and papers.
She knows her stuff. She’s also really helped a friend of mine and the referral came from him. I had every reason to trust her and feel good about putting myself in her hands.
However, I was nervous getting ready to see her. I filled out a diet diary… what would she think? What would she say about my blood work? Would she be nice? Would she be understanding? Would we get along?
Survival instincts kick in.
We talked about a few things in the first visit (which cost an arm and a leg, but will be worth it if I’m left feeling great) and she prescribed some supplements for me to take.
I left, kind of satisfied. Ready to get on with our journey, with a list of things to pick up, dosages to tweak, things to consider and instructions to book again in 3 to 4 weeks.
Ok.
I woke up this morning, in the early hours tossing and turning, thinking to myself, “I don’t want to take vitamin E!” And “Did she truly understand my concerns?” And “what are all these supplements treating?” and “did she really hear me out?” And, “is all this going to actually help?”
The impulse to not trust, to run and hide, to override her assessment and recommendations with my own were overwhelming. (And, of course, as someone who does what she does for a living, the struggle to overcome this is real, we’re “experts” on the body, but it’s nice to let someone else give direction for a change, especially someone with 30+ more years’ experience).
Still, trusting is hard.
Being aware of the impulse to run and avoid, while also resisting the impulse, is hard.
I have people who neglect booking a follow-up even when they know that we still have lots of work to do.
I have people who don’t fill out diet diaries for fear of actually taking a hard look at their food intake.
I have people who email me that “nothing is working” when in fact they haven’t started taking their nutrients and supplements yet.
And, guess what, as frustrating as that may be (because ultimately, I want people to have success! I want people to heal), I’m doing the same thing.
Jeez, being in the patient chair is mighty humbling.
I highly recommend it to all my health practitioner colleagues out there.
And, yes, now I’m taking vitamin E. I’ve decided to just trust. (But I’m still taking my own multi-vitamin… hey, doctors make the worst patients… amiright?)
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!
