I didn’t plan to specialize in hormones. I trained as a naturopathic doctor with a focus on mental health, drawn to questions of mood, anxiety, resilience, and meaning. And hormonal health found me anyway, as a language that explained everything I was already seeing.
It feels fitting that a naturopathic doctor would focus on hormones because hormones don’t belong to one organ or one diagnosis. They belong to systems that connect everything in us to everything else, like a tree with many branches and extensive root networks. They connect us to nature. They are shaped by food, sleep, stress, safety, relationships, and time. They respond to the world we live in, cycle with the sun, moon, and seasons, and undulate through the decades of our lives, affecting how we feel, think, crave, and cope.
Naturopathic medicine views the body as an interconnected ecosystem, and hormones serve as its communicators, keeping our parts in conversation. They respond to and influence our emotions, habits, cravings, fertility, and energy levels.
Hormones ebb and flow across the day, the month, the year, and the lifespan in predictable rhythmic waves. When those waves shift out of tempo, symptoms emerge: disrupted sleep or nighttime waking; anxiety, low mood, or increased emotional reactivity; fatigue or reduced stress tolerance; changes in body weight or composition, especially around the abdomen; and menstrual changes, such as heavier, more painful, or irregular cycles. This is when most of us seek help from the medical system.
The medical model is built on a reductionistic framework that assumes one symptom means one problem, and that the solution is to remove, replace, or suppress the malfunctioning part. Diabetics need insulin, depressed individuals need serotonin, and pain needs to be suppressed through analgesics or anti-inflammatories: one problem, one malfunction, and a neat one-drug solution.
Sometimes these interventions are coherent, necessary, or life-saving. And sometimes they oversimplify, making a more dynamic, rhythmic, and circular conversation linear. In the worst case, they override physiology and obfuscate the body’s attempts to find balance, sometimes worsening the underlying condition and causing unwanted side effects.
Hormonal conditions spill out of the clean lanes of the reductionist medical model. I often have patients come in or write to me with various concerns: anxiety, fatigue, weight gain, sleep issues, heavy periods, changes to skin, hair and nails. “I have so many things wrong with me,” many will exclaim, or “I know this sounds crazy, but I sometimes notice—” They often have a long history of being dismissed or medically gaslit by a system that can’t hold or make sense of their experiences. But these rather mysterious and chaotic symptoms often fit into a coherent, predictable pattern of imbalance once we understand how hormones work.
Hormones don’t behave like broken parts in a machine that can be tightened, tweaked, plucked, and patched up. Hormones are nodes in a network. The word hormone comes from the Greek hormao, meaning “to excite” or “to set in motion.” They are signalling molecules released from endocrine glands such as the ovaries, thyroid, adrenals, and pancreas that travel through the bloodstream to convey information to every body cell about metabolism, ovulation, energy, mood, cravings, and sleep.
These messages respond to and adjust to the body’s internal and external environments. They respond to physiology, stress, safety, meaning, nutrient levels, sunlight, time of day, and food. Oftentimes, they are trying to find balance in a system where communication is interrupted or distorted.
When one thread in this communication web is yanked, such as chronic stress, disrupted sleep, under-fueling, or inflammation, other parts shift to compensate in an effort to find balance. Symptoms often indicate that the system is not broken, but adapting.
Throughout my years of clinical practice, I have spent a lot of time teaching my patients about their hormones. I believe when we know better, we can help ourselves feel better. After all, the word doctor comes from the Latin word docere, which means “to teach.” One of the naturopathic principles is the tenet “doctor as teacher.” I firmly believe that healthcare providers have a duty to care for our patients through education, support, and empowerment. Informed consent is essential in medicine, and you cannot give it without the right information.
I wish we knew more about our hormones.
I’ve had several patients on oral contraceptives (“The Pill”) claim that their periods are regular, coming every twenty-eight days like clockwork. They were offered the pill to “regulate” their cycles, and none of them were taught that the pill doesn’t produce a menstrual period, regular or not, but a well-timed withdrawal bleed.
Regular cycles, more than being convenient, are important medically because they more often than not indicate regular ovulation. Ovulation is necessary for producing progesterone, a hormone that gets little attention compared to estrogen but that is essential for sleep, bone health, metabolism, skin health, and mood. Women with PCOS, or endometriosis, or perimenopause, or hypothalamic amenorrhea are not menstruating regularly because they are not ovulating regularly. Sometimes they are put on the pill to “regulate their cycles,” but the pill does not support ovulation; it suppresses it in order to prevent conception.
Oral contraceptives aren’t wrong; they are a miraculous technology that has revolutionized society, women’s rights, and women’s health. Many of my patients, upon learning that the pill isn’t actually regulating their cycles, choose it anyway. And that’s absolutely fine. However, we have a right to understand what interventions are doing in our bodies: what they suppress, what they add, and what effects to expect. We have the right to informed choice, not to be told that a medicine is doing one thing, like regulating cycles, when it is actually doing something entirely different: suppressing ovulation and creating a bleed at regular intervals once the hormonal pills in the pill pack are paused.
Many of my patients in their 40s are unaware that perimenopause can start in their late 30s, and that early symptoms include changes to mood, menstrual cycles, and sleep well before the first hot flash. In our youth, we were given books about our periods and taught how to use condoms. I wish, in our late 30s, someone would interrupt our work and caregiving responsibilities to hand us a manual on perimenopause and what to expect in our upcoming decade of hormonal change.
If we understood our hormones, we might be able to anticipate, recognize, and respond to these changes, rather than seeing them as concerning personality change, meeting them with fear, or consulting endless practitioners who might also be clueless about perimenopause. There are only 7,000 PubMed studies on perimenopause. In contrast, there are over 1.2 million studies related to pregnancy. Half of humanity is women, and every woman who lives long enough will go through perimenopause, yet this remains a niche area of research.
I wish my patients in their 40s could discern what information is useful and what is not when it comes to Google searches, long lists of supplements, or advice from influencers.
Not everyone may or should choose hormone replacement therapy, but I wish more of my patients were informed of its risks and benefits, how it works, and what each hormone does in the body, choosing based on values, symptoms, and health goals rather than fear.
Much of the hormone replacement conversation around perimenopause and menopause focused on estrogen replacement. Progesterone, however, is anti-inflammatory, acts on nearly every cell in the body, and declines once ovulation becomes irregular or absent, sometimes as early as age forty. Perimenopause has recognizable phases, and many of them begin with low or unstable progesterone.
I was once on a bus reading a book about hormones, and the woman beside me, glancing at the title, remarked, “Hormones, I’ve heard about those. They say they’re important.”
Hormones aren’t just important; they’re the web that keeps everything together, creating the very experience we were sharing, being on the bus, thinking about hormones, conversing with one another. This woman was somewhere in her 50s, and I supposed that she had no idea that vasomotor symptoms like hot flashes, and future bone, cardiovascular, and metabolic health are all deeply tied to hormonal levels and can all be affected by the hormonal change of menopause.
I’m not sure what her perimenopausal journey looked like, but an in-depth conversation about hormone therapy with her doctor might have improved her quality of life and health trajectory as she ages.
I’ve seen a myriad of patients told that their thyroid labs are normal, without context. Patients have come into my practice on dozens of supplements, spending hundreds on specialized hormone testing without understanding what they offer (or don’t) or how to interpret the results.
Many symptoms are dismissed by the medical establishment as “stress” or “aging.” Stress is an important hormonal input, as the stress response itself is hormonally driven, but stress is not one thing. It has phases, shapes, durations, and distinct manifestations. Stress hormones interact with and are impacted by nervous system capacity and resilience. These hormones shift ovarian, thyroid, and metabolic hormones in various ways.
Many of us (an estimated 88%) sit somewhere on the insulin-resistance spectrum, often without our awareness. This can result in abdominal weight gain despite no meaningful change in diet or exercise. It can also contribute to symptoms like anxiety, low mood, pain, fatigue, and low energy. Insulin resistance, or even diabetes, is not simply “a bad diet,” but a distinct hormonal pattern that is influenced by menstrual hormones like estrogen and progesterone, stress hormones, and circadian rhythms.
Many people with insulin resistance aren’t even aware they have it, instead reassured that their glucose levels are normal because we aren’t taught how insulin works or how to advocate for insulin testing.
This gap in hormonal research and healthcare leaves us open to influencers and social media marketers swooping in. We are inundated with conflicting health advice from online professionals and various health “experts” who all swear they have special knowledge and a unique solution. We’re sold complicated plans and protocols, and oversold supplements, in the hope that they will relieve our suffering. But these solutions are imposed without an understanding of what is causing symptoms. Understanding is everything because it helps you discern and choose wisely.
The most expensive, fancy supplements are often not the most indicated or effective for your particular pattern or condition. The most effective plans are often those chosen with context, and the right ingredients, forms, doses, and timing in mind, where the intervention is matched to the specific presenting pattern.
To understand hormones, our bodies, health, and nature, we must become systems thinkers of the Biopsychosocial Model. Systems thinking asks not what is broken, but how our parts interact. Instead of isolating a single symptom or lab value and treating it as a standalone problem, it examines how different systems in the body influence one another.
In hormones, this means understanding the ongoing conversation between the adrenal, ovarian, thyroid, and metabolic systems. These systems are connected and constantly communicating with our biochemistry, organ health, and external environment. A change in place, such as constipation or a lack of light exposure, ripples throughout the human body.
Systems thinking also requires a sense of time. Hormones don’t just fluctuate day to day; they shift across weeks, months, years, and lifetimes. Puberty, contraceptive use and disuse, peak fertile years, perimenopause, and menopause are transitions that reorganize the system, alter physiology and how we experience energy, mood, motivation, appetite, and even self-trust.
When hormones are viewed through a systems lens, symptoms stop feeling random and become information. We can start tracing the threads back to identify where the system might be under strain, what it is adapting to, and what support it is asking for.
This way of understanding hormones also requires interoception: the ability to sense and interpret what is happening inside the body. Interoception is how we perceive internal signals, such as hunger, fatigue, tension, warmth, restlessness, and calm, before they become symptoms or diagnoses.
Interoception is more than a “gut sense.” It is embodied awareness paired with understanding. Without context, bodily signals can feel confusing or alarming, but with context, they become useful data that we can learn to decipher and respond to. We can observe a gradual shift in menstruation or mood, including pain, sensations, energy levels, and swelling. We can learn to interpret shifts in stress exposure, blood sugar, inflammatory load, recovery, and felt sense of safety.
For most of human history, this kind of awareness was reflected in how we lived. Bodies were understood in relation to light and dark, hunger and satiety, and the seasons of activity and rest. Menstrual cycles were observed alongside lunar cycles. Energy rose and fell with daylight. Fertility, recovery, grief, and productivity were shaped by seasons, weather, and community demands. This wasn’t mystical knowledge so much as practical attunement, an understanding that bodies change in response to time, environment, and meaning.
Much of that literacy has been lost as modern life flattened time and disconnected us from natural cues. Regaining it requires paying closer attention. Through tracking, reflection, and education, we can rebuild a relationship with our bodies that was once cultural and natural knowledge.
Tracking can help build this awareness. When we track sleep, energy, mood, appetite, and cycles, and learn the signs of ovulation, we can shift our relationship with our bodies, riding the waves of hormonal rhythms with ease rather than being thrashed around by them. This is how we build agency.
Health is not the absence of disease or even the feeling of being well all the time. I believe health is an empowered state of connection with our bodies, where we become fully engaged in their care, as we are with a child or a pet. What am I feeling right now? What does my body need?
I also believe that naturopathic medicine is not just about the interventions: whether it be supplements, nutrition, acupuncture, or even medication like hormone therapy. There are many responses that might be appropriate for an individual depending on their context, values and health goals. The difference is collaboration and choice. No matter how gentle or effective the intervention, the best one is that chosen with information and consent.
Too often, we are handed a prescription without being told what it does, what it changes, what information it obscures, or what alternatives exist. That lack of context erodes trust not only in the medical system but also in one’s own body. The implied message is that the body is something to fear, manage, control, and override.
In other instances, we are actively taught to ignore our bodies, told the message is “all in our heads,” that labs are normal, and we are fine. This attitude can delay a diagnosis of endometriosis by as much as 10 years. During that time, people are often told their pain is normal, their symptoms are stress-related, or that they should simply manage. Interventions may be offered, but without curiosity about the underlying pattern that can be associated with infertility, anxiety, and bowel changes, along with painful periods.
Hormone therapy is another important topic of nuance. Women in midlife are prescribed antidepressants more often than hormone therapy, when the “root cause” is a shift in hormones, not brain chemistry. We need to have more conversations about hormone replacement grounded in evidence rather than fear.
Much of the public conversation about hormone therapy is shaped by outdated interpretations of research, incomplete explanations of risk, or oversimplified narratives that swing between panic and promises of anti-aging.
Bioidentical hormones, for example, are often discussed as if they are either a miracle or a marketing gimmick. In reality, the term simply refers to hormones that are structurally identical to those produced by the human body, such as estradiol or micronized progesterone. These hormones have been studied extensively. Their effects, benefits, and risks depend on dose, timing, route of administration, and the individual context of the person taking them. None of this can be reduced to a single headline or blanket recommendation.
Dose matters. Timing matters. Whether hormones are taken orally, transdermally, or vaginally matters. Age, symptom profile, metabolic health, inflammatory status, and cardiovascular risk all matter. Research reflects this complexity, but that nuance is rarely translated into patient-facing conversations. As a result, many people are either frightened away from therapies that could help them or pushed toward them without sufficient understanding.
Agency in hormonal healthcare does not require rejecting medical care, but we should be informed enough to participate in decisions. We should understand what therapies are intended to do, what trade-offs they involve, how success will be evaluated over time, and what testing can show. It means knowing when a symptom is expected, when it signals the need for adjustment, and when further investigation is warranted.
The patients who tend to have the best outcomes with hormonal health interventions are supported in understanding their bodies as dynamic systems. They are given time, information, and follow-up. They are allowed to ask questions. They are not rushed into decisions, nor are they left to navigate complex choices alone.
Understanding our hormones is not about memorizing biochemical pathways, hunting for a single root cause, taking on extensive lifestyle changes or expensive, heavily marketed supplement regimes, nor is it about approaching the body as something that needs to be fixed.
Instead, learning about hormones is about orientation and learning where you are in a larger pattern and how the system is shifting over time. You learn how to participate in decisions rather than feel subjected to them. You know what questions to ask, what information matters, and what changes are expected versus concerning.
Most importantly, it allows you to interpret change without panic. Hormonal systems adapt and fluctuate. When those fluctuations are understood within context, they can be met with curiosity, adjustment, and care rather than fear, urgency or self-blame.
I wanted to respond to this information gap by creating a course on hormone health. I didn’t want to offer a quick fix, another set of rules, protocols, or promises, but to share the framework I use clinically when people come in confused by their symptoms and unsure how to make sense of what their bodies are doing. I wanted to create a resource that walks you through your hormonal systems so you can feel empowered in your health.
This course replaces late-night Googling. In 10 modules, I teach you how to recognize patterns as they shift; understand hormonal changes across cycles, seasons, and life stages; ask better questions; interpret information without panic; and participate more fully in decisions about care.
I gathered everything I’ve learned from the hundreds of books, research papers, and courses I’ve taken, as well as the thousands of patients I’ve worked with to create a course for women who want to understand hormones without reducing themselves to a diagnosis, a lab value, or a label, and who want a way of relating to their bodies that is informed, grounded, and humane.
Because I wish women knew more about their hormones.
References:
Bluming, A., & Tavris, C. (2026). Estrogen matters. Penguin Random House.
Briden, L. (2018). Period repair manual. Pan Macmillan Australia Pty, Limited.
Brinton, R. D., Yao, J., Yin, F., Mack, W. J., & Cadenas, E. (2015). Perimenopause as a neurological transition state. Nature Reviews Endocrinology, 11(7), 393–405. https://doi.org/10.1038/nrendo.2015.82
Hitchcock, C. L., & Prior, J. C. (2012). Oral micronized progesterone for vasomotor symptoms—a placebo-controlled randomized trial in healthy postmenopausal women. Menopause, 19(8), 886–893. https://doi.org/10.1097/gme.0b013e318247f07a
Huberman Lab Podcast. (2024, June 3). Dr. Mary Claire Haver: How to navigate menopause & perimenopause for maximum health & vitality [Video]. YouTube.
Hussain, A. (2024). The period literacy handbook: Everything you need to know about your menstrual cycles, period. Period Literacy School.
Mattern, S. (2019). The slow moon climbs: The science, history, and meaning of menopause (1st ed.). Princeton University Press.
Mosconi, L. (2024). The menopause brain: The new science for women to navigate midlife, and optimize brain health for later years. Allen & Unwin.
Romm, A. (2021). Hormone intelligence: The complete guide to calming hormone chaos and restoring your body’s natural blueprint for well-being (Unabridged ed.) [Audiobook]. HarperCollins B and Blackstone Publishing.
Rossouw, J. E., Anderson, G. L., & Prentice, R. L. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women’s Health Initiative randomized controlled trial. JAMA: The Journal of the American Medical Association, 288(3), 321–333. https://doi.org/10.1001/jama.288.3.321
Weschler, T. (2003). Taking charge of your fertility: The definitive guide to natural birth control, pregnancy achievement, and reproductive health (Revised ed.). Vermilion.
“If you try this and hate it, we’ll learn something.”
Sometimes a great plan brings no relief. Many patients come into my practice having read, researched, consulted, and asked thoughtful questions for years. They have tried different diets, bought various supplements, gone to therapy, and seen multiple practitioners. Some things may have helped briefly, then outcomes faded. Other protocols or so-called solutions felt overwhelming and expensive, preventing them from even starting.
We are surrounded by conflicting advice, and each new option carries the burden of dashed hopes, “What if this doesn’t work either?” Over time, choosing starts to feel more challenging than staying uncertain. We want to feel better, but the act of committing to a plan, a practitioner, or a direction feels utterly exhausting.
This is a common experience for patients entering the holistic and natural health space, where treatment plans often involve lifestyle changes. Sometimes, even well-meaning practitioners dismiss it as “noncompliance” or “lack of readiness.” But the issue is rarely a lack of will, motivation or intelligence. Patients in this state are often highly active and engaged in healing. Over time, enough disappointment, overwhelm, or contradictory guidance leads their bodies to expect that effort won’t lead to results. Their system isn’t refusing to heal; it’s protecting them from the emotional cost of choosing and the heavy shame of bearing the responsibility.
When people are actively seeking solutions but repeatedly struggle to initiate or sustain action, the system responsible for authorship is already overburdened. Low agency arises when we feel that authorship of our lives is unsafe, exhausting or futile. Many who struggle with follow-through have lived for years, often since childhood, in environments where choice wasn’t safe.
If you struggle with decision-making and commitment, you may have grown up learning that trying often came at a cost, such as overwhelm, criticism, or collapse.
Over time, your body may have learned to conserve energy by waiting rather than acting. This was never a conscious decision you made, but an intelligent adaptation. In nervous system terms, chronic stress, trauma, illness, or prolonged uncertainty can pull the system into shutdown or freeze states, where initiating action feels heavy, confusing, or risky. You want to change, but struggle to implement change over time.
I’ve seen this pattern many times, often in people with complex histories. A patient might come in carrying a heavy file of childhood trauma. Perhaps they come to me with a history of disordered eating, chronic pain and fatigue, emotional volatility, panic, and depression. They’ve been waiting, sometimes for months, for the “right” referral, the specialist who will finally have the answer. When that appointment arrives, the encounter is brief and decisive. The recommendation may be a strict diet, testing and supplement protocol, or medication. Collaboration is non-existent, follow-ups are sporadic, and the style of care is directive: do this to feel better.
And sometimes, remarkably, it works, at least at first. Symptoms ease within days. Pain lessens and mood lifts; the relief is real. Through my years of practice, sometimes watching this from the outside, I’ve found it disorienting. After many sessions of careful pacing with clients facing many struggles, they seemed miraculously cured by authoritative, sometimes heavy-handed interventions, and I’ve often wondered whether my slower, gentler, collaborative approach was wrong.
But, over time, I came to understand what often unfolds next. Without ongoing support, context, or integration, these intensive plans become unsustainable. For patients with a history of restriction, control, or collapse, the intervention slots perfectly into an old binge-shame-control-restrict-rebel-shame cycle. After a period of deprivation, without nervous system scaffolding and the structure in place to hold these significant changes, patients inevitably slip through the cracks, falling off the plan and spiralling into shame and self-defeat.
Not only does relief disappear, but so does the sense of being held by an authority that had the answer. Disappointment deepens, leading to further collapse, and what remains is paralysis: no clear way to continue, no internal compass for deciding what changes mattered, what helped, or how to adapt.
Healing doesn’t fail because the intervention was wrong, misguided, or useless, but because something essential, something required for healing, was never named or built.
In these moments, agency, or rather the lack of it, becomes visible. Intense, immersive fixes can feel irresistible precisely because they temporarily relieve the burden of authorship. We don’t trust our capacity to steer, decide, or stay with change because our system has never been taught to do so. And so an external structure feels like salvation. We are exhausted, miserable, and in pain and in these states, containers like retreats, protocols, charismatic practitioners, and tightly defined rules offer certainty. And certainty temporarily regulates a system that feels uncertain and chaotic.
When these structures disappear or fail to fit our realities of daily life, we’re left holding the responsibility for our health and lives, and without support, it becomes too heavy to carry. The resulting collapse under this weight is a predictable nervous-system response, not failure.
Early in my practice, I felt this tension acutely. I understood, intuitively and philosophically, that patients heal themselves, and that my role was to guide, explain, and support. This is explicit in psychodynamic psychotherapy, where healing comes not from answers, but from understanding oneself in the presence of a steady, attuned other.
I noticed, however, that in medical settings, many patients are understandably impatient with nuance. Patients are dealing with troubling symptoms that demand an answer. In our healthcare system, we are trained to defer our bodies, agency and choice to an authoritarian expert. In this context, I could feel the pull to become that leader: more directive, more convincing, even more “magical.” But, I knew that while this stance might improve short-term compliance, it would undermine the very thing required to heal: agency.
Patients struggling with low agency want to heal but don’t yet trust themselves to carry the process. When patients appear indecisive, demand authority, or continue gathering information, they’re often asking not for more answers but for help tolerating the vulnerability of change. As clinicians, we can misread this (I often have) and respond by adding more plans, complex explanations, and intense structure, thereby unintentionally increasing the load on a system already at capacity.
Many so-called miracle cures follow this arc. They rely on pressure, urgency, restriction, or intensity to push a nervous system into action. For a time, this can feel like a transformation. But without integration, these highs often collapse into more profound shame, fatigue, pain, or shutdown. The lesson isn’t that these experiences are meaningless; in fact, they can teach us a great deal if they’re reflected on and metabolized. The problem is that without support, the learning often never consolidates. We usually view these experiences as something out there that works, but that we failed somehow.
The problem was never the plan, or practitioner; it was the mismatch between the agency the intervention required and the agency the patient had access to at that moment.
In psychology and medicine, several concepts overlap with what I’m describing here, including self-efficacy, locus of control, autonomy, and learned helplessness.
Self-efficacy refers to a person’s belief that they can carry out a specific action. Self-efficacy predicts why confidence is needed for follow-through and why low confidence can trigger avoidance and early abandonment of plans, but agency is not just about beliefs. Low agency is not about a lack of doubt in one’s ability to act, but a system that can not tolerate the act of authorship itself. The problem isn’t confidence or belief, it’s capacity.
Locus of control describes whether someone experiences outcomes as internally or externally determined. In other words, do we believe our actions matter or that outside forces dictate them? An oscillating locus of control can overlap with the pattern of deference to authority, followed by rebellion and collapse when one struggles with agency. Still, it doesn’t account for the emotional or physiological costs of choosing.
In Self-Determination Theory, autonomy is a felt sense that one’s actions are self-endorsed. Research consistently shows that behaviour change is more durable when autonomy is supported rather than coerced. However, Self-Determination Theory assumes a baseline capacity for autonomy. This article points to something that lives upstream of that assumption: with patients whose systems are not yet able to tolerate autonomy without threat.
Learned helplessness comes closer to describing how repeated, uncontrollable stress can reduce action, even in the face of options. Learned helplessness maps well onto chronic illness, long diagnostic odysseys, healthcare trauma, and repeated disappointments over attempts to heal. However, it is often framed as passivity rather than high-effort, high-seeking, low-integration patterns that many chronically ill patients are trapped in.
In the late 1960s, psychologist Martin Seligman and his colleagues ran a series of experiments that came to be known as the Learned Helplessness Studies. In one version, dogs were placed in a situation where they received mild, unavoidable electric shocks. No matter what the dogs did, move, whine, or try to escape, the shocks continued. Later, those same dogs were placed in a new environment where escape was easy: a low barrier they could step over to stop the shock. But the dogs learned that their actions didn’t matter, and so many of them didn’t try. Their agency was extinguished.
In contrast, dogs who had never experienced uncontrollable shocks quickly learned to escape. This experiment has since been ethically criticized and is no longer conducted, but its implications have echoed through psychology, medicine, and trauma theory.
When we repeatedly encounter situations in which effort doesn’t change outcomes, we stop initiating action altogether. Seen through this lens, what we often call “lack of motivation,” “self-sabotage,” or “giving up,” can instead be understood as a learned nervous-system adaptation: why try, if trying hasn’t helped before?
Similar to learned helplessness, low agency is a state of the nervous system, not a personality trait. It often shows up alongside chronic fatigue, metabolic dysfunction that doesn’t respond to lifestyle change, health anxiety, autoimmune illness, and depression. Patients arrive depleted and foggy, frustrated by their inability to initiate or sustain change. They desperately want to feel better, so they ask for testing, supplements, diagnoses, and explanations. On the surface, they’re asking for energy. Underneath, they’re often asking for amelioration from the burden of choosing and carrying their lives. Their systems have been in collapse long enough that surrender feels like the only imaginable intervention.
Suggestions that require sustained action, like regular meals, movement, and supplement consistency, can feel intolerable because they demand a level of authorship the system doesn’t yet have access to.
As a clinician, I felt this as pressure to find the one thing: the right supplement, the proper test, the correct explanation that would finally ease all symptoms. Sometimes that treatment exists. More often, cases are complex and rooted in long-standing patterns that shift only with steady, consistent inputs: changes that require feeling the body change and tolerating what that change brings.
For years, I focused on insulin resistance and metabolic dysfunction as key root causes of hormonal, cognitive, and mood symptoms. Often, this framing was correct. When the labs finally provided a coherent explanation, it felt like a solace for both of us: now we know what to do. I’d suggest a small set of actions, such as movement, nutritional guidance, a supplement, and sending patients off with hope.
Sometimes they improved, then abandoned the plan for something more extreme or restrictive that actually worsened the problem. Frequently, the issue wasn’t the plan. It was that the body was changing faster than the nervous system could metabolize the responsibility of maintaining that change.
Anxiety often reflects this same struggle with authorship. Many patients are highly vigilant: researching, anticipating side effects, seeking reassurance, listening to podcasts, tracking opinions. On the surface, they look engaged. But the engagement is often in the service of control rather than action. The moment a concrete choice is made, like starting a supplement, stopping a food, or setting a boundary, anxiety spikes, and the system retreats into analysis.
Depression, particularly with states of shutdown, involves a profound loss of agency, a loss of the felt sense that actions matter.
In chronic illness, where one feels betrayed by their body, low agency can appear as endless consultation without integration. Patients might move from practitioner to practitioner, accumulating opinions, tests, and plans that never consolidate. Each new expert destabilizes the last, but choosing one path means letting others go, and that loss can feel threatening. Authoritarian care can worsen this by overriding agency through pressure or shame.
Low agency can also show up as over-identification with external authority. Some defer completely to doctors, diets, and ideologies, only to rebel or collapse when asked to sustain the change. Rather than defiance, this reflects confusion about where the self ends and the other begins, often rooted in early experiences in which separation and autonomy were shamed, forbidden, or unsafe.
In practice, this can look like repeated requests for plans that are never used. Meal plans sit untouched. Supplement lists are partially followed, altered, and questioned. The plan becomes a symbolic container for hope rather than a tool for change.
Trauma is often at the center of this pattern. Trauma isn’t only about what happened to us, but what happened to our agency. When initiative was punished, ignored, or exploited, the body learned to stay still. In adulthood, this can look like indecision or endless seeking without consistent action. Beneath it is an intelligent truth: staying small once kept me safe.
Agency can be grown, however, in small, meaningful and survivable steps. It doesn’t come from overhauling your life, but from choosing one thing and staying with it long enough to feel the consequences and survive them emotionally. Agency isn’t a trait that you have or don’t have; it’s a capacity that can be rebuilt.
Consider the smallest action you could take that could be repeated without resentment or collapse. Maybe it’s laughably simple. Eating protein at breakfast, taking your iron supplement consistently, walking for 10 minutes after dinner, or not responding immediately to a triggering email. These are not trivial actions; they are repetitions of agency. Like each rep of a bicep curl, each one is an opportunity for the nervous system to learn: I chose this; something happened, and I survived it. That learning is what builds capacity.
Agency is the nervous system’s bandwidth to make a choice, feel what happens next, and remain intact, emotionally and relationally, through the consequences. Often this means doing less, not more. Complexity can destabilize collapsed systems.
If a plan immediately triggers anxiety, obsession, or the urge to rebel or abandon it, that’s not a moral failure; it’s information. The system is saying, This is too much right now. Plans that are too detailed, too perfect, or too ambitious can actually erode agency by reinforcing the sense that healing is too big to hold.
Time-limited experiments can help. Rather than framing changes as permanent commitments, saying things like, “This is my new diet,” or “This is who I am now,” frame them as experiments with a clear beginning, middle and end. This reduces the existential weight of choice. The nervous system relaxes when it knows there’s an exit: at two, four, or eight weeks. And this makes follow-through more likely.
When agency is fragile, the real task is not optimization. It is learning how to stay with one small choice long enough to experience yourself as the author of it.
A helpful practitioner for rebuilding agency is not the most impressive, directive, or confident one. It’s someone who can tolerate uncertainty without rushing to fill it, who doesn’t escalate complexity when things stall, who respects pacing. Someone who can say, “Let’s try this and see what happens. If you hate it, we can try something else,” and mean it. Someone who doesn’t confuse care with control.
If a practitioner feels all-knowing, rescuing, or possessing secret knowledge, this can feel comforting at first, but often undermines agency over time. It invites outsourcing rather than authorship. On the other hand, you might feel abandoned by a practitioner who offers too many choices and no structure at all.
The sweet spot is containment without domination, and guidance that leaves room for choice. The work of the clinician is not to find the perfect solution but to scaffold agency gently, through simplicity, repetition, containment, and tolerable choice.
Tolerating authorship is often the most challenging part of building agency. Authorship means accepting that outcomes are not fully controllable and that success or failure will belong, at least in part (but never in whole), to you. For many people, this is where shame, grief or fear surface. We might think, if I choose this and it doesn’t work, what does that say about me? About my body? About my capacity to heal? If I feel better, can I sustain it? If I take responsibility, will I be blamed?
Learning to tolerate authorship means staying present with those feelings rather than fleeing into analysis, seeking reassurance, or endlessly choosing. It means practicing saying, internally, I don’t know, but I’m willing to find out by trying something. That is a profound nervous-system shift.
The most challenging part of healing is often not doing something new. It’s staying with it. It’s tolerating the uncertainty, the effort, and the sense that now the outcome depends partly on us. In this realization, there is often grief. On the other side of the grieving process, however, is healing.
Reflection is also part of agency, but it needs to be simple and embodied, asking questions like, Did this feel stabilizing or destabilizing? Did this give me more energy, or did it drain me? Do I feel more resentful or vigilant? Is what I’m feeling a high of healing, a sense of relief, or actual change? These are questions that build interoception, the ability to read internal signals, which is foundational to agency.
Agency is relational; most of us don’t lose it alone, and we don’t rebuild it alone. Safe relationships with a practitioner, therapist, friend, or group provide external regulation that supports internal and self-regulation. The goal is not dependence, but supported autonomy from someone steady enough nearby that you don’t have to outsource your decisions, but don’t feel alone with them either.
It helps to let go of the idea that agency means doing everything yourself. Agency does not mean isolation. It means choosing consciously where you accept support and where you take responsibility. It’s the difference between saying, “Just tell me what I should do,” and asking, “Can you help me think through my options?
When we develop agency, choices become easier, less dramatic, and less charged. Healing stops feeling like a series of make-or-break decisions and becomes a rhythm of choosing, feeling, adjusting, repeating, and creating sustainable change over time.
Healing is not about finding the perfect plan. It’s about building the capacity to stay with yourself while living one.
References:
Apigian, A. (2025). The biology of trauma. Simon & Schuster.
Dana, D. (2020). Polyvagal exercises for safety and connection: 50 client-centred practices (Norton series on interpersonal neurobiology) (1st ed.). W. W. Norton & Company.
Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268. https://doi.org/10.1207/s15327965pli1104_01
Maier, S. F., & Seligman, M. E. (1976). Learned helplessness: Theory and evidence. Journal of Experimental Psychology: General, 105(1), 3–46. https://doi.org/10.1037//0096-3445.105.1.3
Maier, S. F., & Watkins, L. R. (2005). Stressor controllability and learned helplessness: The roles of the dorsal raphe nucleus, serotonin, and corticotropin-releasing factor. Neuroscience & Biobehavioral Reviews, 29(4-5), 829–841. https://doi.org/10.1016/j.neubiorev.2005.03.021
van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma (1st ed.). Penguin Books.
I wanted to share a recent story about my experience with the Carnivore Diet and Low Insulin Lifestyle. Maybe it’s because I just finished watching Netflix’s Apple Cider Vinegar, but sharing my health experience feels strange: very health-influencer-esque. There is some mention of weight and weight loss and some mention of body image and my relationship with food, but that’s not really what the story is about: it’s about insulin. I know I’ve shared things of this nature before, and sometimes, weaving stories can add some humanity to what might otherwise be a cold and clinical onslaught of health information.
So, if you find the idea of reading about me intriguing or even entertaining, read on. As usual, remember that this is my experience and can’t be extrapolated to everyone. Let’s talk in a clinical setting if you read something that resonates with your experience and want to learn how it might fit your health history and goals.
Last summer, something shifted in my health. Maybe it’s the same thing that happens to most women around this age (late 30s), i.e., the catch-all explanation-replacement for “it’s just stress”-perimenopause. Maybe there was a shift in how I was taking care of myself, although it felt like I was staying on top of everything. I walked a lot, went outside, and ate fruits, vegetables, and protein. But something still felt off.
And the thing that felt “off” was what so many patients often complain about. I felt… well, I had gained some weight, and not just physical weight. I felt mentally and spiritually heavy. The weight seemed to pile on out of nowhere. I shun the scale and rarely weigh myself, but one day, I did. The jump in number was so big in such a short time that my judgey scale asked if I was the same person who had weighed in 3 months before. Wow. Nice…
The heaviness wasn’t without its causes. That Spring, I finished my Masters of Counselling Psychology–a long, almost three-year slog. Shortly after, my 15-year-old dog, Coco, stopped eating for four days. He was diagnosed with protein-losing enteropathy and put on a daily dose of liquid prednisone, a steroid. Coco has been with me from the start of all this, when I first filled out applications to attend naturopathic college. He slept beside me during late nights of studying. He came with me to my exams. The sleepless nights, the decision-making, weighing the responsibility of senior pet ownership–when to intervene medically, when to decide to end his suffering, of course, the sheer financial cost– was a lot to grapple with and went on for months. It’s still going on, to be frank.
That summer, my Nonna passed away a few weeks before her 97th birthday.
I wondered if it was grief, or stress, or even steroids getting on my skin, but I felt puffy. I was tired. I felt sluggish and less stress resilient. I was still active but doing more sedentary activities: reading and learning guitar.
Weight and digestive issues have been a struggle my entire life. The “healing journey” has led me on some valid paths: exploring food sensitivities and gluten-free living, nutritional support through supplements and nutrient-dense foods, meditation and mindfulness, adrenal support and herbal medicine, and prioritizing rest and mental health.
But, regarding nutrition, I felt I was doing everything I could. I didn’t want to go down the road of caloric restriction. I didn’t want to deprive my body or fight its process. Sometimes, weight is protection. Sometimes, we need a warm, heavy blanket. Sometimes, we need to slow down.
So, I did. Of course, I was tempted by thoughts of how to solve the weight gain by dieting, as so many of us have been programmed to do. I even recorded a podcast about retraining myself to value and preserve my muscle mass rather than trying to become smaller. I accepted this new shape and focused on the tasks: my work, hanging out in nature, surfing, and healing my gut.
My gut health was terrible, although I was managing it based on all the research I had sifted through on my way to creating a gut health course. I added in more fibre and fermented foods. This worked for a time but didn’t solve the problem entirely. For most of last year, my irritable bowel syndrome was wrecking havoc. I was highly distended, often in pain.
I had brain fog and physical sluggishness. I felt stuck in a parasympathetic state. So, I sat on the couch, enjoying slow mornings, reveling in the absence of deadlines. I read books. I went for long walks. That summer, I swam in lakes and went to the Atlantic ocean.
While trying to be patient with my body, I constantly felt that I wasn’t tapping into the energy from my food. I would eat a full day’s worth of food and some stews, legumes, rice, smoothie, and salads and still feel hungry. I was constantly thinking about food. I tried to honour this by just eating more whole foods. I believe the body asks for what i needs, if we’re willing to listen. So I tried my best to listen.
Around Christmas, I was at a cafe with my boyfriend. He was eating a sandwich. Ever since naturopthic college, I have diligently avoided gluten. But I was already feeling sluggish and bloated. I was already tired. And here was a delicious, bready baguette. A delightful sandwich with soft carbs, mayo, cheese, and meat, just inviting me to sink my teeth into it. What good was avoiding gluten doing me at this moment? I avoided gluten to feel energized, healthy and light. I already wasn’t feeling that way, so eff it, how could things get worse?
I took a bite. It was divine. I let myself eat gluten for the next month. Glorious, glorious bread! I felt like my life was straight out of the pages of Eat Pray Love as I gorged on all the pasta and pastries I wanted. I chilled at Christmas parties, eating brie, bread, cakes and pies. I had all the dessert. There were no limits anymore. And, in a way, that food freedom did heal my soul. It was like a vacation from all rules and guidelines. We need this from time to time.
But, if I was barely staying afloat before then, adding in the gluten and sugar made me slip below the surface. I was insanely bloated. My weight soared. I felt sore, stiff, and clumsy. I had significant brain fog. My ankles and face were comically puffy. While I didn’t regret a second of it, after my foray into the world of gluten, I decided it was time for a reset.
After much consideration, a light switch clicked on, and I decided it was time to try the Carnivore Diet.
The premise of the Carnivore Diet is that it’s the ultimate elimination diet. It’s ketogenic, or zero carb, and contains no FODMAPS (fibre), grains, or other allergenic foods. It gives the gut a chance to reset.
While we often hear about how good fibre is for us, the truth is that some research shows that eliminating fibre can heal constipation. Emptying the gut and consuming a low-reside diet, in other words, all the components of the diet are digested and absorbed early on in the digestive tract, can give the colon a break. Further, burning ketones can heal the gut as the primary ketone, betahydroxybutryrate, is food for gut cells (we often hear about butyrate in the context of eating fibre).
Advocates of Carnivore talk about appetite control, abundant energy, healthy digestion, clear skin and effortless ease in maintaining a healthy body weight. I wanted this. I also wanted to feel more connected to my body and its energy processes. I wanted agency over my food cravings. I felt my appetite was out of control and my body needed something it wasn’t getting or couldn’t access.
Within the first 24 hours of Carnivore, my brain fog lifted. After the first week, I dropped 12 lbs . It felt like emerging from the fog into sunshine, and tossing off a heavy cloak.
I felt fully nourished for the first time in a long time. I ate a lot of fat, meat, eggs and even dairy. I felt energized. My appetite calmed down. I woke up in the morning, and instead of rushing something down my throat, I made myself a coffee and felt hunger slowly creep in.
I would prepare a big breakfast of meat and eggs that would hold me until the mid-afternoon. The food noise died down. My brain felt supercharged- I could think again. Even after long hours of talking to patients or working at the computer, I felt my brain could keep going and going and going. I no longer got that white noise static electricity that I associated with oxidative stress caused by overworking my neurons.
My mental health was better than it had ever been. I felt calm, persistent brain energy and agency over my thoughts. I felt emotionally stable and resilient. Nothing seemed to phase me. I felt strong.
I felt great. My original intention was to do the diet for a couple of weeks, but after the first week, I thought, I can do this forever! This is my diet, it’s my way of eating, something about it felt right. It was also the dead of winter. What would I be surviving on if I were in the wild right now? No fruits and vegetables were around; the ground was covered in snow. I would be hunting and killing animals and surviving on their meat. This way of eating felt aligned with the season, and I believe it was what my body needed at the time.
My brain and body thrived on the ketones. I had no cravings. Even on my birthday, I just wanted a nice ribeye steak. I couldn’t care less about cake, potatoes, or any other exciting comfort foods we look forward to on birthdays.
It was hard to sustain the diet on vacation. When I went to Ecuador in late February, I decided to let go of Carnivore and eat what was available. Because of the sun, surf, walking and relaxed vibe, I felt good in Ecuador, but my body felt far from magical. I dealt with chronic gut issues, miserable period cramps and a three-day migraine throughout my time there. On the plane ride back, I was ready to restart Carnivore and found it relatively easy to jump right back in the following day.
I hesitated to talk about my experience on Carnivore even three months into the experience. I felt great. My body felt like an efficient engine, burning fuel cleanly. However, the food was all…well, brown. And salty. And I often felt dehydrated. Also, after the initial drop in weight, I had stalled.
Grocery shopping was a strange experience. It felt surreal to be surrounded by all this… food. Stuff that wasn’t a part of my day at all. It wasn’t the snacks or chips or candy or even the carbs that tempted me. It was the rainbow of fruits and vegetables that greeted me every time I wheeled my cart into the store.
The fruits were shiny and colourful, advertising their sweet, hydrating juices and vitamins. Glycogen, or stored carbs in our muscles and liver, hold water in our bodies. On a low-carb diet, we often burn through our glycogen stores. If there was one thing I craved on Carnivore, it was the sweet hydration of juice.
One day, I was browsing Instagram and saw a comment on a popular account about glucose regulation. The account features a biochemist/influencer who shows a series of continuous glucose monitor graphs and discusses the glucose response to food. Her methods feature tips like “add fat to your carbs to lower your glucose spike.” This post highlighted how adding fat to starches (like hummus, which adds fats like olive oil and tahini to starchy chickpeas) can reduce the height of a glucose spike, helping to regulate blood sugar.
This is something I often coach my patients on, as blood sugar regulation is the key to mood stability, mental health, cognitive energy, and adrenal function, among so many other things. Interesting how I was kind of wrong about that.
The comment that caught my eye was written by a PhD who pointed out that while adding fat and carbs together can lower a glucose spike, it does not change the height and area under the curve of the insulin spike. Adding fat to starches might make the insulin response to food larger, even if it’s curbing and controlling the rise in glucose. It hit me then. We’ve been focusing on the wrong thing. I assumed glucose and insulin were like two twins on a tandem bike. One rises, and the other one joins in. Seesaw, yin and yang. But I started connecting the dots from the cases of patients I’ve seen, my experience, and third-year biochemistry. Yeesh, it’s all about insulin.
I remembered something else, too: the Insulin Index.
88-90% of humans are insulin resistant. We can’t access our fat stores or the energy from our food because we have chronically high insulin levels and unresponsive cells. Insulin’s main job (or maybe its most famous job) is to help drive glucose into shelves. You consume starch, glucose explodes onto the scene, and insulin puts it all away for you. It stores the sugar as glycogen and fat, and your body burns those later for energy.
Naturally, whatever causes a rise in blood glucose will also cause a rise in blood insulin. But sometimes, glucose isn’t rising on a continuous glucose monitor because insulin has already lept onto the scene to bring sugar down. Further, some foods, like whey protein and milk, don’t spike glucose much but will have a (significant) impact on insulin levels.
The commenter, Dr. Ali Chappell, PhD, described herself as an insulin researcher. Her research involves examining the effects of a low-insulin spiking diet on PCOS (an insulin-resistant hormonal condition that affects about 10% of women). The Low Insulin lifestyle was tested on various women who reliably lost 19 lbs in two months without counting, eating as much fruit, non-starchy vegetables, nuts and seeds and animal protein as they wanted. When I discovered Dr. Ali Chappell, I had just been hired to do a course on Insulin Resistance, which involved researching the manifestations and solutions to keeping ourselves metabolically healthy.
While a low-carb or Ketogenic diet like the carnivore diet can certainly heal metabolic dysfunction, it didn’t feel right to recommend this lifestyle to patients. It wasn’t for the faint of heart, for starters, and something in my soul was starting to miss fruit and vegetables. As part of my course research, I began to dive deeper into the low-insulin lifestyle.
Some bells started to ring for me. At the same time, my good friend was struggling on Carnivore because, while she felt great, she was breastfeeding, and the diet was affecting her milk supply. I shared with her what I learned about the Low Insulin Lifestyle. She started on the diet and, within a few days, told me her cravings and hunger were diminished. She was dropping her weight-loss-resistant belly fat like a stone.
After she had been on it for a week, I followed. I was ready to add more colour to my life. I removed the whey protein and dairy I had been eating, thinking it was fine and not realizing it was impacting my insulin. I added more fruits, vegetables, nuts, and seeds. I had dark chocolate again!
The variety was lovely. My gut was ready for fibre again, particularly the soft, gooey, juicy fibres from fruit. It felt good to fill my stomach with bulk. And it felt terrific to eat so many colours and textures of food.
Weight loss that had stalled for months after that initial drop on Carnivore kicked up again. My appetite chilled out, and I felt nourished again. I realized this eating pattern had been something I stumbled on from time to time: my trip to Brazil in 2020, my first forays with Paleo, even following the guidance of a microbiome test I did in 2021. However, none of these experiences involved intentionally targeting insulin. I would often eat starches like sweet potatoes or rice. I sometimes cut out fruit, with its fructose, which has a minimal impact on insulin.
This finally clicked things into place for me. It helped create a framework to encase my intuition around food and what humans should eat.
I was consuming whole, natural foods our ancestors would have consumed. Unprocessed plants and animals. Lots of healthy fats. Lots of sugar from fruit. Phytochemicals from colourful plants. Protein and nourishing fat from meat, eggs and some yogurt or cheese. I ate berries and burgers. Salads, broccoli and asparagus. I had sausages with organic tomato sauce. So many bacon and eggs breakfasts. I had nuts and seeds and pumpkin seed butter. I had dark chocolate and bananas. Pistachios. Shawarma meat and salad (hold the rice). It was easy to make decisions and figure out what to eat.
Looking back, I think glucose intolerance has plagued my whole life. It has affected my body and my relationship with food. It led to years of binge eating that only stopped if I ate more consistently. Protein helped immensely.
When things started to feel off, I consulted with a family doctor. I ordered some bloodwork through her and did some myself. My fasting insulin levels and insulin sensitivity (HOMA-IR) value were normal. However, when we eat foods spike insulin, it can cause a post-prandial (i.e., post-meal) rise in insulin that can stay elevated all day, as we go from one meal to the next. It can spike hunger and cravings, causing us to eat and continue to boost insulin. While hyperinsulinemia can lead to insulin resistance, I don’t think my body was there quite yet. I was raising my insulin levels, blocking my body’s access to energy stores and driving the hunger, inflammation and heaviness I was feeling.
Insulin sensitivity and glucose tolerance tend to shift as our hormones change through our late 30s and 40s. As estrogen and progesterone levels change, insulin levels increase, and we become more insulin resistant. This explained that shift I felt. The old patterns of diet and exercise I was engaging in weren’t working either. I needed to be more intentional with the way I was eating and exercising.
I started adding in more resistance training, scheduling in weights and high intensity interval training two to three times a week in addition to my yoga, swimming, and walks. The carbs from fruit helped fuel my muscles. I felt myself shift out of that parasympathetic shutdown state. I watched my nervous system enjoy more flexibility.
In a few weeks, I will start filming my course on insulin resistance. Then, it will go to editing. I’ll let you know when it’s time for it to be released. The course has been a gift. It allowed me the space and time to dive deep into the research and start putting various bits and pieces together. Metabolic dysfunction is the great health crisis of our age. I’m becoming more and more convinced that it drives so many of the common concerns we see in natural medicine practices: SIBO and candida overgrowth, adrenal fatigue, estrogen dominance, and chronic inflammation. There is a whole budding field of mental health called “metabolic psychiatry” that examines the role that insulin resistance has on mood and brain health.
Until proven otherwise, if a patient is dealing with high insulin, we must address this as a potential root cause that ties together all their concerns.
The medical establishment often overlooks insulin resistance, as the primary focus is on diabetes, which represents a later stage on the disease continuum. Decades of dietary advice have also set us up for metabolic inflexibility and an overabundance of dietary glucose that overworks insulin and blocks our ability to use energy for brain and body health.
The good news is that I believe the solution is simple. Eat a diet that leaves insulin alone: animal protein, nuts and seeds, fruits, non-starchy vegetables and healthy fats. Leave aside the starches (grains, legumes, root vegetables) and sugar. Add in some higher intensity training and work your muscles. With this approach, we have the start of a full-blown health revolution on our hands.
Stay tuned for more podcasts and courses on this topic in the coming months!
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.”
I’ve struggled with body image as much as the next woman. In certain influencer, nutrition and health circles I find “skinny” is confused for “healthy”. When we talk about health and wellness, people assume we mean “thinness”, or weight loss. And I want to confess something: I hate treating weight loss. I love love love when people notice positive side effects from their treatment plans: they’re sleeping better, more relaxed, have better skin and yes, have even noticed some weight loss, but when weight loss is our primary goal, something we’re aiming for at all costs, (and this is the key point) beyond the weight OUR BODY WANTS to be for health, then I’m often stumped. My goal is to support the healing process of the body, and to do no harm. Fat, while vilified in our society, is not a 4-letter word. (I also mean that literally… it’s… a 3-letter word). Our bodies love fat. Fat is stored energy. It’s your cushy bank account—resources saved for a rainy day. It’s mental, emotional, and physical protection. Our cushioning protects us against falls. It’s a storage reserve for reproductive needs (growing a baby’s brain and breast-feeding). It’s the rubber insulation of the electrical wiring of our nervous system and brain. It’s brain mass. It’s a layer of warmth. Stress, famine, lack of sleep, inflammation, and hormonal resistance, are some common signals that tell the body to store and maintain fat. Our bodies also have a set point range at which they feel most comfortable—and this set point, unfortunately for our Instagram followers, may be higher than society tells us it should be. I have found in my practice that if we treat the underlying causes of fat gain: the inflammation, poor sleep, chronic stress, insulin resistance, etc., we might notice weight loss as a happy side effect of improved metabolic functioning. Sometimes our bodies have experienced mental, emotional, physical or metabolic trauma and need to hold onto their protective layer a little while longer. Maybe your body thinks you need a little softness… I created a course: Intuitive + Mindful Eating, body image, metabolic health, hormones and more.
So, if another diet “failed”, trust me, that’s normal. It’s not your fault. Diets don’t work. In fact, in the long run they do the OPPOSITE of what their supposed to do: improve our metabolic health. Instead they DAMAGE our metabolic health, through cyclical restriction (which often leads to binging and weight gain). And this leads to guilt, shame, and a poor relationship with our body image and food. The solution is to work with your body where it’s at. – Understand how your metabolism works, and learn about your Set Point Weight. – Listen to your cravings and hunger cues and use them as tools for communicating with your body to heal your metabolism – Make peace with your body size through developing Body Neutrality (easier to achieve than body positivity for a lot of people) and becoming more “embodied”–feeling at home in your body vs. trying to change it. – Recognizing that you can feel at peace with your body where it’s at right now: and that losing weight (if it means working against your metabolism) won’t make you healthy. And it won’t make you happy. – Making peace with food through Intuitive and Mindful Eating. – Practicing gentle nutrition that honours hunger cues and cravings and keeps you fuelled throughout the day. – Self-compassion – Understanding how hormones play a role in body size and metabolism and how to nurture them to feel your best. I cover all of this in more in my course You Weigh Less on the Moon. Because it’s true, you do!
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:
That feeling that you can’t settle. You can’t eat. You can’t relax. Your muscles are tense.
Not all is right with the world. Many people who live with chronic low-grade anxiety don’t even realize it’s there.
I see this all the time in my patients who experience panic attacks (when a couple of straws “break the camel’s back” so to speak, the “backs” being a nervous system that is already tightly wound up), or dissociation, even depression, or chronic exhaustion.
Chronic low-grade anxiety can occur if something happens to us that our nervous systems don’t yet understand. I was babysitting a dog for a few days and she and my dog got into a fight. It was nasty and it rattled my nervous system.
I found myself feeling wound up… needing to be soothed, to be settled, for someone to tell me that it wasn’t going to happen again. My response is to go into “information” mode, to poll people, to get an authority’s perspective.
But, of course, it’s impossible to have certainty in this world. And so, my nervous system was asking for something: either that the situation wouldn’t happen again, or that I would know how to handle it and make things alright if it did.
Those with a history of childhood trauma may live in a state of hypervigilence and chronic anxiety–for you it might be your default state, like oxygen, anxiety is always there, at the very baseline of your experience.
The experience of low-grade anxiety is terrible. You’re always vigilant. You’re obsessing, you can’t relax. Your startle reflex is completely uptight.
You have nightmares, you don’t feel hungry. And yet you suddenly feel light-headed and starving.
Everything feels like too much.
Symptoms of chronic low-grade anxiety:
brain fog
overwhelm
disrupted sleep
feeling jittery or shaky
nausea
lack of hunger
extreme hunger
tense, sore muscles
digestive issues, IBS, bloating, diarrhea
generalized sense of dread
shortness of breath, or difficulty getting a full breath
sweating
fatigue
and so on
How do you heal it? Well, it’s tough because ultimately the nervous system wants you to REASSURE it that the world is a SAFE PLACE.
And… it’s not.
Shit happens.
It’s a bumper sticker for a reason.
Shit happens and when it does we need resources.
These resources come in the form of physical nutrition: literally salt, glucose and water. They come from stable hormones (related to blood sugar, a properly functioning circadian rhythm), managed inflammation.
They come from restorative practices: exercise and rest, time where you feel into your body. And they come from understanding the situation: storying it.
In the case of the dogfight, it helped me to learn about dogs, to know how to keep them calm and happy, to understand their particular language and establish myself as the dog leader (also lots and lots of exercise and a bit of CBD oil).
Once they were calm I was calm too.
In the case of childhood trauma it might involve working with the story through the support of a trusted therapeutic relationship, and maybe after working on building resources and engaging in stabilizing practices that help you feel embodied.
Therapies to treat chronic low-grade anxiety:
nutritional practices focused on obtaining essential nutrients like fat and protein and stabilizing blood sugar
support circadian rhythms, sleep and cortisol responses in the body
support neurotransmitters and cell membranes
trauma-informed therapy, or Cognitive Behaviour Therapy
movement
meditation and self-compassion
breathwork
emotional regulation, self-soothing and other embodiment practices
time in nature
plenty of rest
regular routines and self-care-informed habits
plant medicines that can help access deeper seated trauma or regulate the nervous system, hormonal systems and brain chemistry.
And so on.
Our nervous systems are beautiful things. They’re trying to tell us something.
A nervous system on edge is telling us that all is not harmonious with the world: perhaps our internal world, or our external one.
