Self-Care Practices for Constipation

Self-Care Practices for Constipation

New Doc 8_4I feel sorry for the digestive tracts of this nation, I really do. The owners of these digestive tracts have my sympathy as well—there really is nothing so bad as pooping too much or not pooping enough. Sometimes it’s hard to know which one is worse. Having regular and healthy bowel movements (1-3 times a day) is an essential foundation of good health—regular elimination helps us remove toxins and waste from the body, keeping us energized and well.

A series of patients often come through my office with chronic constipation that is unrelieved by supplements and diet. Most people are getting enough fruits and vegetables or have added more of these foods to their diets and still have a hard time keeping things moving in the lower abdominal quadrants. Since promoting healthy motility is often about daily self-care practices, I’ve complied my list of constipation home-care protocols here, for easy reference. While there are herbs and supplements that can improve motility, add fibre and draw water into the colon and promote healthy elimination, there are also foundational daily practices that must be incorporated as well.

Water:

A no-brainer: we all know that if stools are dry and hard to pass, we need to increase the lubrication of the digestive tract. Gradually increasing your fluid intake by one glass (250 ml) of water per day per week will help your body adjust so that you’re not sent running to the washroom every ten minutes.

Most importantly, however, I like to tell my patients to start the day with a large glass (500 ml) of room temperature water, consumed at once, first thing in the morning. This stimulates the gastrocolic reflex, by filling the stomach with water. In a healthy digestive tract, the contents of the intestine should move through the gut and enter the colon over night where they await the morning meal. Stimulating digestion by ingesting a modest amount of water first thing in the morning can stimulate the contraction of the colon and encourage a bowel movement. Keeping water warm or at room temperature, rather than cold, prevents the water from seizing up the body’s sphincters and allows things to keep moving. This practice also guarantees half a litre of water consumption a day, which we know is essential for proper colon health.

Listening to the body:

Slow motility is often a response to lifestyle. Our bodies send gentle cues to our conscious brains that it’s time to have a bowel movement and oftentimes these cues are ignored. Perhaps we’re in traffic, or rushing out the door, or in a meeting. Perhaps we’re afraid to use the washroom at work, where the acoustics are less-than-ideal. However, when we ignore the calls of nature, we often miss our chance to have a bowel movement for that day. If this has become a reality for you, some bowel retraining might be in order. Bowel retraining involves picking a time of day when it would be most convenient to have a bowel movement—right after breakfast is often a good time—and sitting on the toilet for 10 to 20 minutes. This daily practice will help teach your bowels when a good time to go is, as well as make you conscious of making daily elimination a priority. Think of it as “potty training” for adults.

Fibre:

We all know that regular bowel movements require an adequate amount of dietary fibre. Fibre creates bulk in the intestines, feeds healthy gut bacteria and increases stool weight. A healthy diet contains at least 25 grams of fibre a day from whole food sources. However, when it comes to constipation, not all fibres are created equally. While soluble fibre, from things like chia seeds, oats and legumes has been shown to decrease cholesterol absorption in the gut, it can actually serve to bung us up more. Insoluble fibre, like the kind found in apple skins, flax and wheat bran, can help bulk up the stools and keep things moving smoothly along the digestive tract.

To increase insoluble fibre in the diet, I recommend 2 tbs of ground flaxseed (you can add it to smoothies, morning cereal or the morning 500 ml glass of water) a day. This not only helps promote bowel movements, it also provides healthy omega 3 fats and estrogen-balancing properties for healthy hormones.

As fibre needs to absorb water in order to promote healthy excretion, it is important to prioritize fluid intake. A study involving 63 participants showed that the more fibre they consumed, the more constipated they became. The researchers likened this phenomenon to a traffic jam—add more cars and you simply worsen the traffic jam. Therefore, it’s important to keep the gut sufficiently lubricated to encourage proper motility.

Castor oil packs and self-massage:

Castor oil can help promote smooth muscle motility when applied topically to the abdomen. I instruct patients to massage a liberal amount of oil over the entire abdomen (bra-line to underwear line) and either place a hot water bottle over the area for one hour or leave the oil on overnight. Self-massage paired with castor oil are effective at helping things move more regularly throughout the night. A word of caution, however: castor oil should not be used in pregnancy and before an expected menstrual period as it can stimulate the contraction of the uterus. Castor oil also has the potential to stain clothes and bedsheets, so take extra care.

Pelvic tilt:

A few years ago, the Squatty Potty was all the rage. This new, rather expensive tool, claimed to change the angle that the legs make with the torso, encouraging pelvic floor muscle relaxation and relaxation of the muscles around the anal sphincter. The principles makes sense—we humans have evolved to evacuate our bowels in a squatting position. This increases abdominal pressure and causes puborectalis muscle relaxation, allowing us to have a strain-free experience. The modern toilet, however, does not encourage this angle, which the makers of Squatty Potty claim is the reason that constipation issues are so rampant in Western society. I encourage purchasing a 1-ft high washroom stool to place under the feet while going to the washroom to promote proper posture and sphincter opening.

Exercise:

Daily exercise promotes bowel movements by increasing metabolism, increasing intra-abdominal pressure and strengthening abdominal muscles. Getting 30 minutes of moderate exercise (walking, swimming, cycling, etc.) and performing squats are excellent ways of promoting healthy elimination.

Talk to your naturopathic doctor:

Supplements such as magnesium, vitamin C, probiotics and certain herbs such as burdock, peppermint, chamomile and chicory can also help with constipation. Talk to your naturopathic doctor about what doses, brands and supplements are right for you. Acupuncture and hydrotherapy are also useful treatments. Try to avoid methods that only offer temporary relief from constipation, such as laxative use. These can help in the short term, but like most short-term treatments, can worsen symptoms in the long term and further exacerbate your efforts to promote healthy bowel movements over time.

How to Reinvent Your Life in 20 Steps

How to Reinvent Your Life in 20 Steps

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

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

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

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

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

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

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

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

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

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

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

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

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

10) Exercise. Enjoy some movement every day.

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

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

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

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

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

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

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

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

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

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

A Naturopathic Approach to Healthy Hair

A Naturopathic Approach to Healthy Hair

IMG_5360This is likely one of the shallowest posts I’ll ever write—it’s about hair. However, what is so shallow about hair? We all know the importance of having a good hair day. It seems from the moment we wake up, look in the mirror and notice that our top bun has left proper, succulent waves and not weird, irregular angles of frizz, that the rest of the day will be infused with magic. Our hair plays a huge role in who we are and how we see ourselves. When movie characters want to change their identities, the first thing they do is stash themselves in a truck stop bathroom with a box of hair dye and go to town on their manes. Further, and admittedly sticking to the shallow side of things, I’m often suspicious when every photo of a man on Ok Cupid shows himself wearing a hat—what on earth is he hiding? At any rate, concerns about hair health gets people, namely women, into my office. Sometimes seemingly shallow, trivial health concerns act as gateways to lifestyle changes and a journey to health and wellbeing. Since our bodies don’t really require hair for survival, hair health, along with sex drive and energy, is one of the first things to decline when we enter into a state of imbalance. It therefore becomes an important initial warning sign that things have gone array with our health.

Hair holds a significant place in our self-perception and daily routines, often influencing our confidence and identity. When hair health falters, whether due to genetics, hormonal changes, or lifestyle factors, individuals may seek solutions like Hair Restoration Therapy to regain a sense of normalcy and well-being. While the desire for lush locks may seem superficial to some, it often serves as a catalyst for deeper introspection and lifestyle changes, underscoring the interconnectedness of physical appearance and overall health.

Hair loss is often a concern for many women and men. It’s normal to notice a few strands of hair in the shower—the average woman loses about 50 to 100 strands of hair per day. However, when patches of hair seem to be missing, areas of thinning are present or a reduction in overall hair volume (usually indicated by a decrease in thickness of the pony tail), this can point to possible pathological hair loss.

In the quest to address concerns about hair loss, the choice of shampoo becomes a crucial element in maintaining scalp health. Opting for a sulfate free shampoo for oily scalp emerges as a thoughtful strategy to navigate this common challenge. This type of shampoo not only gently cleanses the hair but also ensures that the scalp’s natural oils are preserved, striking a balance that is particularly beneficial for those experiencing issues like thinning or reduced hair volume.

While losing a few strands daily is normal, unusual patterns of hair loss can signal pathological conditions that may require medical attention.

History and Labs:

When coming in to see your naturopathic doctor, he or she may ask you the following questions:

Do you notice any itchiness or flaking of the scalp? These symptoms could indicate a number of skin conditions of the scalp that contribute to hair loss: seborrheic dermatitis, infection by a fungus called Malassezia furfur that causes dandruff, or psoriasis of the scalp, an autoimmune condition. The ND may diagnose via trial-and-error or perform skin-scraping to rule out a fungal infection. A skin biopsy may be indicated to provide a definitive diagnosis, however this test is invasive.

What do you labs look like? Comprehensive lab work is necessary in patients with hair loss. It’s important to see what iron status is, as well as thyroid health. Low iron or under-functioning thyroid can be the root cause of hair loss as can high androgens, the male sex hormones.

Which medications are you taking? Oral contraceptives can cause a deficiency in vitamins and minerals, such as zinc and B vitamins, that can cause hair loss. Other medications that can cause hair loss include, and or not limited to, blood pressure medications, antidepressants, antibiotics, acne medications, chemotherapeutics agents, immunosuppressants and pain medications. An ND can work with your doctor to decrease your list of medications by addressing the root cause of concerns, if possible, or collaborate in switching medications. This, of course, will only be done in collaboration with the prescribing doctor.

What’s bugging you? Stress can contribute significantly to hair loss. The mechanism of action is varied, but a decrease in circulation to the scalp, protein deficiency and depletion of vitamins used by the adrenal glands, can be possible causes of hair loss. Telogen effluvium is a condition where the body pushes the hair follicles into a “resting phase” so that they no longer grow and produce hair. This is done because when under stress, the body enters survival mode and does not dedicate precious resources to non-survival entities such as hair health. Alopecia areata an autoimmune condition in which the immune system of the body attacks the hair’s follicles, causing large patches of hair to fall out. This is said to be cause or aggravated by severe stress. Trichotillomania is a mental health condition in which the individual plucks out hair as a self-soothing mechanism.

What are you other symptoms? Weight gain, irregular periods, acne and hair growth on the face can indicate PCOS, which also can cause loss of scalp hair due to higher-than-normal testosterone levels. Men with high testosterone will also experience more hair loss. Digestive symptoms can indicate malabsorption of important fat-soluble vitamins or iron, which can contribute to hair loss if resulting in deficiency.

What hair products do you use? A sensitivity to sulphates and/or other chemical additives to hair products can contribute to hair loss or a decrease in the lustre and overall health of hair follicles.

Treatment:

The naturopathic treatment for hair loss, involves identifying and treating the root cause of symptoms, not the hair loss itself. A potential treatment plan might consist of the following:

Restoring health by replenishing depleted or deficient vitamins and minerals.

Eliminating infection or scalp fungus if necessary.

Managing stress in healthy, constructive ways.

Balancing hormones and the immune system via herbs, supplements and dietary changes.

Nourishing the hair by adding in vitamins that support hair health, such as fish oil. This also involves changing shampoos and conditioners to more natural, sulphate-free forms.

Castor oil hair mask:

Once a week, when my hair starts looking drier and duller, I do a castor oil hair mask and scalp massage. Castor oil is an anti-fungal and anti-inflammatory oil. It has the added benefit of increasing blood flow to the area it is applied to, in this case the scalp, which can increase hair growth. It is also a wonderful moisturizer and nutrient-rich hair supplement. It can help fuse together and moisturize split ends. Performing a self-scalp massage is a great way to increase body love by performing self care and has a grounding effect on the body, which reduces mental-emotional stress.

Apply a liberal amount of castor oil to palms. Rub oil into palms to warm it. Starting at the scalp, work oil into the hair follicles, applying a firm pressure and moving the fingertips in circles. Massage for 5 minutes, moving the oil through the shaft of the hair to the ends. After performing massage, leave oil in hair for at least an hour or overnight. Finally, shampoo and condition hair as usual to remove oil. Warning: castor oil can stain fabrics so sleep with an old pillowcase and wear an old t-shirt while performing castor oil scalp massages.

Epilogue: If you haven’t noticed, this seemingly shallow subject matter is the perfect segue into talking about a basic naturopathic approach, which involves taking a thorough history, ordering lab work to find the root cause of symptoms and then treating accordingly using non-invasive therapies that aim to treat the cause, not just the symptoms themselves. Notice how this is vastly different from walking into a supplement store and purchasing a product called “Hair Loss Formula” or some other facsimile. While this formula may replenish some deficient vitamins, it is masking the real cause, which may be PCOS or celiac disease, and delay effective treatment for these conditions. Hopefully this highlights the importance of seeking a professional opinion rather than self-diagnosing and self-prescribing!

Self-Care and Political Warfare

Self-Care and Political Warfare

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

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

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

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

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

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

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

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

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

Self-care builds resilience.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Self-Care Resources:

Methods-of-Self-Care : Free Ebook

Caring About Self-care : Article

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

Gratitude Journal Part 2

I’m grateful for endings

that merge into new beginnings,

karmic cycles and their painful lessons

and excruciating yearly rituals that often end

in transformations.

 

I’m grateful for long late-night horizontal conversations

tiny loving gestures

unity

and the Universe announcing her timing

loud and clear.

 

For experience.

 

For strength and resilience

reflected

in the mirror.

 

For friends and family who linger

around the corner

ready to reemerge

when you call them.

 

For cold winter winds that bring loss

and change

and propel us on.

 

For memories that needn’t be analyzed;

they’re simply gifts to cherish and remember.

 

The winter winds push us

on through the frigid night

into spring.

Listening to My Body (and why my pants are too tight)

Listening to My Body (and why my pants are too tight)

New Doc 7_5I am in my grade 12 photography class. I am 17 years old. I have my head on the desk in abject despair, as I succumb to the intense stress that was my last year of high school, where every academic move I made would dictate my future. I remember catching sight of my thighs nestled on the hard-backed plastic chair beneath the desk. And, although my struggles in that moment were seemingly unrelated to my body, I remember feeling a sense of satisfaction as I made a mental note of how the once-curvy lines of my thighs were straightening themselves out, flattening and loosening some of the fat that cushioned my thigh bones. From this satisfaction, I drew a sense of calm; I was losing weight, therefore things would be all right. The notion sounds ridiculous now but, at the time, I associated thinness with all the things I valued: friendship, love and even success. These things could only take place in someone inhabiting a thin body. I would, naturally have to complete the prerequisite of achieving “thinness” before I could have any of those things. This belief, rather than creating a connection between the rest of my life and my experience in my body, only served to fragment my bodily experience, as I tried to form my shape into the mould I thought it should inhabit.

Fast-forward more than 10 years later. There is a sale at a store I used to frequent as a teenager. Since all my jeans have the coordinated foresight to spring holes at the same time (between the thighs, naturally), I decide to go in and try on some pants. When I realize that I take a full two sizes smaller than the last time I ever slid this brand of jeans over my hips, my chest is filled with the same contented bubbling I experienced that afternoon in photography. The anxiety of my future – my career, my empty wallet and my relationship -relaxes. I walk out with two pairs.

I am wearing the jeans on the subway when I run into my former boss. She and I chat about the weather and the school and she tells me that her young daughters refuse to wear pants because “they encumber their knees at circle time.” We chuckle at the humor of the situation and my mind travels to my closely wrapped thighs, feels the snugness of denim surrounding them. For me, pants serve as a container for the flesh that threatens to spill out of them. I remember wondering when my definition of “comfort” evolved from the freedom of the body to expand, move and breathe to this feeling of secure confinement I experience inside my jeans. I doubt these pants would allow my knees to properly stretch themselves out and bend at circle time. Luckily, when you’re pushing 30, you get to sit in chairs while people tell you stories.

As a naturopathic doctor, I preoccupy myself with the relationship our bodies have with our environment and lifestyles: how do the products we use affect our hormones? How does the food we eat and the movement we engage in affect our internal terrain? How does our mindset prevent disease? What I often don’t ask is how the learned relationship one has with their body affects health. Does the way I view my lower body cause me to engage in behaviours that affect my health? How are my tight jeans impeding lymphatic flow? How do they affect my digestion? Does my sense of self-worth affect my blood sugar? The answer is it absolutely can, if my sense of self-worth causes me to ignore my body’s food cravings and hunger signals. The way we treat ourselves and imagine our own health stems from our relationships with our bodies, which in turn dictates our future health states.

Susie Orbach, a feminist psychotherapist and author, once wrote that female babies are breastfed for less time, and picked up and cuddled less than male babies. She goes on to describe how this early treatment of women, “characterized by emotional deprivation and feelings of unentitlement”, secures the female’s place as a second-class citizen in society. More than that it teaches women to disconnect with our bodies. If our needs are not met at an early age, we are led to believe that these needs are wrong. We are taught to ignore the smelling, farting, bleeding, overflowing, curving bodies we are born with and try to recreate a “false body” that is perfect and that begins to believe it is “comfortable” being squeezed and starved and stuffed into pointy-toed shoes. Or we simply develop the ability to de-identify with the discomfort. This mechanism can lead to injury or disease if we fail to truly listen to what our bodies are trying to alert us to. (Matthew Remski writes about this extensively in his amazing research project on yoga injuries called What Are We Actually Doing in Asana (WAWADIA). I’ve been devouring his articles this week).

Orbach goes on to theorize that the symptoms the body produces in a disease state just might be a cry for help; the body is attempting to insist on its existence, to demand to be heard. So what then are menstrual cramps? Are they simply a result of inflammation or a hormonal imbalance caused by lifestyle or are they attempts made by the body to cry out, “I am female! I am menstruating! I am in need of attention!”

I remember a patient I had who would deny herself life pleasures. Convinced she needed to lose weight, she would ignore her hunger signals, even proudly telling me that she would turn to her stomach and tell it to “shut up” when the grumbling became too loud. Her chief complaint was chronic pain. I wonder if her body’s pain was simply its way of telling her it existed. I wonder if she’d have found a way to sufficiently answer her stomach’s calling, the pain would have subsided. Perhaps by listening to the experience of our bodies we can start to properly take care of our health. We can start by wearing comfortable pants that don’t “encumber the knees”, moving naturally, embracing our sexual appetites, feeding ourselves the food we truly crave and answering the need for physical touch and rest.

In a society that tends to view the body as an object, a machine that sometimes gets jammed with inconveniences such as pain, menstrual issues and eczema, I wonder how our collective health would change if we began to experience the body as a tool for healing and self-growth – something inherently wise.

To share one last story, I remember sitting across from Teresa, our school counsellor, while I was still a naturopathic student. At the time I was deciding to break up with my then-boyfriend thereby ending a 5-year relationship. I told her I had never been clear on the difference between the fear and apprehension that came with seizing something good and the repulsed feeling of avoiding something bad. This has led me to make decisions in my life that weren’t necessarily right for me. She asked me to cultivate the two feelings and locate their positions in my body. “See if there is any difference,” She told me. As I tuned in I immediately noticed that fear was closer to my heart. It was higher up and it bore the faint pleasant glow of excitement behind its initial anxiety. Disgust was located lower down. It felt like a stomach ache, a sense of doom, of indigestion: a hard-to-digest truth. It was in this moment that I fully appreciated the body’s wisdom. The old adage “listen to your gut” began to ring true to me. My gut was sending me a message that was loud and clear, but it was up to me to listen to it.

So what are some exercises we can do to cultivate body awareness and re-inhabit our bodies? 

– Practice regular body scan mediations, such as those prescribed by the Mindfulness-Based Stress Reduction (MBSR) model taught by Jon Kabat-Zinn.

– Try Susie Orbach’s “Mirror Exercise” in her book Fat is a Feminist Issue or spend 3 minutes a day for 21 days staring at a body part that you have a hard time identifying with. By staring at the nose you’ve always felt was too big on a regular basis, you are able to incorporate it into your sense of self and accept it as something beautiful, in the way you would come to love the same nose on your grandfather, daughter or dear friend.

– Set a timer every hour while at work to remind yourself to tune in to your body and your breath. Notice your feet planted on the floor and move your awareness up through your feet to the top of your head. Ask yourself if there’s anything your body needs: are you thirsty, hungry, bored or lonely? Do you need to stand up and stretch? Do you need a hug?

– Get regular acupuncture or constitutional hydrotherapy to help the flow of Qi through the body.

– Finally, touch yourself. Practice ayurvedic self-massages or apply a natural moisturising lotion or oil before bed. Practice self-care in the form of hydrotherapy. Even placing the hands over the heart and breathing into that area will help to release oxytocin, a hormone responsible for love and bonding, creating feelings of calmness and attachment to the physical body.

5 Detoxifying Herbs for Spring

Spring is about cleaning. The April rains wash away the dirt and grime from the winter, people emerge in fresh, light clothing, we tackle the stacks of papers on our desks, sweep out dust and clutter, open the windows to allow fresh air to ventilate our lives and donate old, knobbing winter sweaters to charity. Spring is also the season of the Liver and Gallbladder in Chinese Medicine. This means that our body’s ability to clean revs itself up at this time of year as well. Some wonderful plants also push their way through the ground. Pick some from your garden and start throwing them into everything you eat. Spring is in the air!

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The Art of Ayurvedic Self-Massage

I await my first real patient: a referral from a friend. I know this new patient suffers from chronic migraines, related to stress, and I am excited; I already have some ideas about what to prescribe. It’s been 9 long years since I decided that I wanted to enter into a healing profession and soon I will be face-to-face with a real human, someone who requires the skills I have so painstakingly acquired over the years through hours of book-study. I am elated. The appointment is cancelled, however, as I am attacked by a migraine headache myself, one that I used to suffer from regularly but haven’t experienced in months. The headache is all-encompassing and I am forced to go home. It’s only on reflection, months later, that I realize the irony of being forced to cancel an appointment due to being afflicted by an attack of the very condition I was to treat.

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Body Blitz and the Vitamin D Shake

Body Blitz and the Vitamin D Shake

It had been a while since I’d truly taken a vacation. After handing in 4 case management forms (CMFs) and writing 1 exam, and endless weeks of seeing patients in clinic, putting the health of others above and beyond my own, I decided that I would hang back from my rat race of assignments, expectations and obligations and indulge in a little self-care at my favourite hydrotherapy haven, Body Blitz.

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