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  • What Happened to Mindfulness?

    As a therapist who uses mindfulness as a theoretical tool, strategy and therapeutic method with my clients, I get concerned when I see the word “mindfulness” used to foster elitism.  Lately I’ve seen people from the fitness industry, food industry and hospitality industry label themselves as “mindfulness experts”.  It is also being used to brand classes, events, products and services.  What’s ironic about this is that - mindfulness – by its definition – is not something that can actually ever be mastered. 

     

    Mindfulness is the awareness of what is happening now and "now" is always changing

     

    I doubt the Dalai Lama himself would label himself as an “expert” on anything let alone a “mindfulness expert”.  Mindfulness is not something that I master in one aspect of my life rather it is applicable to all aspects of my life.  Therefore, I get confused when I read that someone is a “mindfulness expert” because they practice a regimented diet or exercise routine or because they practice meditation and teach meditation to others or because they have been financially successful with an idea or concept.  I would argue this may not be mindfulness at all but rather good fortune, determination, talent and execution. 

     

    When something – like the practice of mindfulness- becomes elitist- a divide begins to happen.  There becomes those who are “experts” and those who are “deficient” or “wanting”.  With isolation also comes competition.  Suddenly the practice of being consciously aware of yourself – free of judgement- is a full-on contest and all mindful aspects of the practice are lost. 

     

    So – what can you be if you cannot be an “mindfulness expert”?  You can be a practitioner, a student, a specialist, a scholar, a veteran and so on..

     

    Words matter.  We have enough that divides us as a people.  Let mindfulness be the thing that brings us closer together through our shared humble practice. 

  • Indistinct and Indivisible

    I for one am still awaiting the day that clinicians such as myself are incorporated into general medicine practices – so that patients coming in for a standard physical each year are engaged by a mental health clinician and assessed for behavioral well-being.  Why has this day not arrived yet?  What will it take? 

    The answer I believe exists somewhere in the compilation of research that now, without a doubt, shows the link, if not the integrity of the entire human system, brain and body.  However, this research does mental health clinicians no good if it’s not recognized.  And I mean recognized by the mental health community itself.  There is still a propensity towards separating brain and body in diagnosing clients, discussing their symptoms and even in dialogue with the clients themselves as if there is no biological basis for the symptoms a client presents with in therapy.  If we, as clinicians, aren’t clear on our own beliefs about the brain/body connection how can we expect not only the government and insurance agencies to be, but even more so, how can we expect our clients to integrate the two which we know is critical for repair and reprocessing?    

    We’ve spent all of this time pushing for equal consideration under health care and now that we’re at least getting closer, why are we still referring to depression or post-traumatic stress disorder as if they were separate and distinct diagnosis’ from a client’s physical display such as low heart rate variability, obesity, back pain, fatigue etc.?  The words we use to describe the conditions that our clients suffer with is critical.  How we talk about it with the client and how we talk about it with the public matters.  The divide between physical and mental health is indistinct now.  I have consolidated some revealing medical research that dispels the division herein starting with some of the more recent discoveries.

    Dr. Rachel Yahuda of Mount Sinai found in her groundbreaking research on epigenetics spanning 2003-2006 that the stress hormones of those suffering with post-traumatic stress disorder do not return to baseline after a perceived threat has passed.  This constant elevation in stress hormones leads to memory and attentional problems, sleep disorders and other long term health issues.

    Scott Wilson and Richard Kradin at Massachusetts General uncovered in the 1999 publication of the their psychoimmunology research that survivors of incest have abnormalities in their immune systems – particularly in the CD45 cells which are the memory centers for the immune system.  This variance in their immune systems makes them oversensitive to threat, mounting a staunch defense when none is really needed.  This provides us with insight into the field of autoimmune diseases, the core characterization of which is the body staging an attack against itself. 

    Frank Putnam, Penelope Trickett and Jennie Noll uncovered in the 2011 publication of their 23 year long longitudinal study of the impact of sexual abuse on female development that survivors of such abuse grow up to experience an earlier onset of puberty and suffer higher rates of obesity among other effects.

    The Adverse Childhood Experiences (ACE) study which started in an obesity clinic in 1998 with over 17,000 research participants documented that individuals who have an ACE score of 6 or above are twice as likely to contract cancer and four times as likely to suffer with emphysema.  An ACE score of 6 or more puts an individual at a 15% greater chance for suffering from diabetes, strokes, Alzheimer’s to name just a few of the leading causes of death in America.

    With this kind of medical research how can we still harbor doubt about the synthesis between brain and body?  Every patient deserves integrated care.  Every patient deserves to have a behavioral health and a physical health clinician working hand in hand.  How else can we practice effective health care?  Until that day patients will continue to focus on their physical problems because they realize, quite frankly, that it is there they will receive better care and coverage. 

  • The Value of Forgiveness

    So often we interchange the meanings of weakness and forgiveness don’t we?  We have come to associate forgiveness with vulnerability and being vulnerable has become a faux pas.  We are nothing if we are not fierce and self-sufficient.  Right?  We strive for perfection.  To be women with no faults or flaws.  And this works for awhile, on the surface.  Until we realize how alone we are.  How ashamed.  How angry and bitter and competitive.  Isolation and anger and resentment prevent us from relaxing which prevents us from regenerating and reconditioning.  We are stuck.      

     

    When we blame others for how we feel or what we have experienced, we keep ourselves stuck in victimhood and inaction.  Each time you react and blame you release the chemicals associated with stress including adrenaline, cortisol and norepinephrine.  Those chemicals limit creativity and problem-solving and lead to feelings of helplessness. 

     

    So what is the alternative?  I offer you FORGIVENESS.

     

    When we forgive the part of our brain responsible for the perception and suppression of pain is activated.  Consider all possible interpretations of a difficult situation; one which might elicit your forgiveness.  Consider the constructive learning that is the result of the difficult experience.  Take responsibility for your feelings by avoiding the displacement of blame and remember the commonality of pain and hurt.  Emotions are universal.

  • Mindfulness in Daily Life

    Mindfulness can be practiced every moment of our day-while you brush your teeth, while you walk from the parking garage to work, when you eat your breakfast or whenever your cell phone rings.  It's about being present.  Making intentional choices.  Responding vs. Reacting (I like the former much better).  We don't even have to be calm to have mindful awareness.  We are capable of being mindful in the midst of our hectic lives.  We must choose to slow down and notice.  What's happening right now?  Right here?

     

    Pick one activity and see if you can do it mindfully this week.  Pay attention to what you are experiencing.  Pay attention to your self-dialogue.  We can momentarily disengage from our activities by taking a long, conscious breath, gathering our attention and then asking ourselves some of the following questions:

     

    What am I sensing in my body right now?

    What am I feeling emotionally?

    What am I thinking?

                                           

    And most importantly, remember that thoughts and feelings are just THAT.  They are not us in our entirety. They are not our sum being.  They pass like all things in life and we are on to another thought and feeling.  Take back your power.  SLOW DOWN

  • Hating Ourselves Thin

    Shame and disgust is where many of us begin our weight loss journey. But self-deprecating, shame driven exercise isn’t a sustainable solution.  The kind of mindset that tells us we deserve to be punished for eating that brownie sundae or those four beers with dinner last night prepares us to have a toxic relationship with the gym, and believe it or not, it maintains that ring of belly fat around our abdomens. 

    When we remain hyper vigilant so too do our cortisol levels.  Cortisol is directly related to our adrenals.  When we feel stressed, (yes when you say crappy, toxic things to yourself and deny yourself love and compassion you are stressing your mind and body!) our body has to create “fuel” in anticipation of fighting, fleeing, or freezing.  When this happens, our brain sends epinephrine and cortisol through the bloodstream converting glycogen and fatty acids into glucose, cortisol converts protein into glycogen and begins the process of storing fat. Cortisol ensures that a surplus of fuel (glucose) is available to us. Your fat never gets a chance to be converted into muscle.  So what is the alternative? Practice 80/20 every day and in every way.  Imperfection is normal.  Self-compassion is more motivating than self-deprication.

  • Building a Bigger Brain

    Aerobic exercise and complex motor activity have different beneficial effects on the brain.  It’s important to do both regularly.  The more complex the movements, the more complex the synaptic connections in the brain.  These connections are critical for building cognitive flexibility; literally they expand your mind.  This expansion allows more space for us to make conscious, intentional, value-driven decisions about what we eat, how we talk to ourselves and so on.  Any motor skill more complicated than walking has to be learned, and therefore it challenges the brain.  We like challenges.  Without them, there are no outlets for all of our energy and it consequently builds up around our midsection.  Our bodies were meant to be “stressed” and by doing so we increase the stress threshold of our minds.  This means we can withstand more of the difficult emotions without having to do something about them (like eating a donut) to get them to go away.  Free yourself up to think beyond the momentary craving and look to the future with the help of regular, complex activity.

  • Food is a Drug Too!

    I was at a conference today in the Ozarks and we were discussing attachment.  In previous WLBC cycles I've written about the human need for "connection".  I was reminded today at this event of that need once again.  Here were a bunch of adults - discussing disconnection - abandonment and breached attachment - and how this is the catalyst of developmental trauma.  We were asked to meditate.  We were asked to share vulnerability with one another - what we were mourning and what we were grateful for.  And many many people were very very uncomfortable. Not surprisingly they, like the rest of us, needed to do something with their pain, with their vulnerability.  They didn't want to share it.  They didn't want to feel it.  Because you see, even clinicians, have avoidance tendencies - especially if they haven't done any of their own therapy.  Alone with their pain - in a room full of "strangers" they reached for CONNECTION.  In its easiest - most tangible form: F  O  O  D.

    Out came the cookies!  Out came the cakes!  Out came the coffee (caffeine-another connection!).  How timely!  Whew!  And they ate.  And ate.  Many of them making second trips to the dessert table.  And nobody said anything about it.  

    Here we were - the instructor directing our discussion to teenagers and their need for horizontal connection (connection to peers, music, icons, drugs, alcohol) because of the lack of vertical connection (parental/mentor) and the audience ate away its own anxiety about the conversation. 

    You see FOOD is often left out of the drug conversation.  It is considered, by our society, to be an acceptable and "good" way of dealing with life's disappointments.  It's so accepted that we aren't even aware of our own eating habits.  Of our triggers.  And suddenly we feel ashamed of the way we look in a bathing suit.  And we have now created a secondary problem for ourselves.  Weight gain.  When the original problem started with a painful emotion, a memory of a terrifying event.  That was the primary problem that got a little out of hand.  So now we focus all of our attention on the secondary problem.  Losing weight.  And we sign up for bootcamps and we go on diets and we withhold and shame and shame and withhold.  And we end up losing some weight!  Woo Hoo!  And we feel proud and we feel relieved because we have told ourselves that the "problem" is how we look, is the weight we've put on.  But underneath, remains that pain, that terror, that loss which we still haven't quite dealt with.  And so when bootcamp ends and we feel a loss of connection again because we aren't connected to that group anymore, to that regimen, we go hunting for something else to connect to...and if we've eliminated food (maybe we return back to food) (maybe we're even managing to keep the weight we lost off) we find something else.  Maybe it's gambling.  Maybe it's shopping.  Maybe it's codependency in relationship.  And we lose ourselves to another horizontal connection.  Further and further off track.  

    Perhaps many of you have seen the NY Times article on the weight gain of The Biggest Loser winners.  If not, here is a link:

    90% of people who lose a significant amount of weight, gain it back within the first 2 years.  

    What is the missing link here?  

    If you've explored and connected to everything but yourself.  If you're considering weight loss surgery.  If you're tired of feeling like your own worst enemy, it might be time to risk getting vulnerable.  To connecting with yourself and not trying to push any feeling, any memory, any thought away.  Maybe the real work is in acceptance and integration.  In naming the fear. Calling it out.  And sitting with it.  Connect with yourself.  Connect with human beings deserving of you.  Bring back your awareness.  

    Be curious.  Be brave.  Be YOU!
    //Julia
  • HAPPINESS is a TRAP!

    The liklihood of gaining back at least half of the weight lost during a "boot camp" or intense physical fitness/diet program is 90%!  This is because real life doesn't operate within the confines of a bubble. There is no coach whispering in our ears as we return to life post-bootcamp.  THIS is the time to really take a look at the 80/20 lifestyle as you make the transition back to your reality.  It is very very easy to set unrealistic expectations on ourselves.  It is very very easy to convince ourselves that forces outside of ourselves are IN control.

    Good questions to be asking yourself include: how am I going to set myself up for a self-care lifestyle?  Who will need to be involved?  What obstacles are expected?  What are my triggers?  How will I intercept negative thinking and negative feeling before it becomes negative behavior?  What are my resources?  

    I think self-compassion means realistic expectations and an acceptance of imperfection.  We do this very silly thing here in America, where we convince ourselves and one another that perfection is attainable and not only is it expected but it's the ONLY way to "happiness".  Whoa!  No wonder we spend so much time and money and energy trying to "improve" ourselves and so little time trying to accept and care for and live in the present with ourselves and our families!  I'm going to say something totally revolutionary now:  HAPPINESS IS A TRAP!  

    "Happy" is one of the maaaaany emotions we have as human beings.  It is a fleeting emotion just like all the rest and yet we treat it as though it is the ONLY emotion that matters, that we should be feeling.  And then we set about on this journey to secure "happiness" and we look at ourselves and others as less than, missing something, void, if we are anything less than "happy".  Guess what?  Life, and all of the other extraordinary parts of you which include disgust, anger, hurt, bittersweetness, peaceful, humbled, alarmed, frustrated, confused are happening and existing while you pursue your "happiness".  Chances are if you are dismissing these parts of yourself, you are dismissing them in others around you, including your spouse and children.  Pretty soon we feel beaten down, like failures, because we spent so much of our lives trying to attain something that was never attainable to begin with!  We feel resentful, hopeless and regretful and often don't understand why or where those feelings come from.  

    START NOW.  Look at all of you.  Allow acceptance in, little by little, day by day.  When we stop pushing away as much, we find ourselves feeling "fuller" and more whole and there is less need for anything outside of ourselves, be it food, alcohol, clothes, money to do the filling for us.  We begin to make choices about what we do, how we do it and with whom from a place of rationality, from a place of self-love and self-compassion and suddenly, for the first time, we find ourselves in a place where our relationship with exercise, diet is less about "fixing" what is wrong with us and more about giving to ourselves because we care about our own well being, about our relationship with ourselves, about our inner dialogue and how that transcends into how we see other people, how we treat them and whether or not we make short sighted, impulsive judgments.  

    Thoughts and emotions and relationships matter.  How you see yourself matters.  These are not separate from how you feel and look physically.  Mind and body are one.  It's time we treat them as such. 

    Be curious.  Be brave.  Be you.

    ~ Julia
  • What is BINGE EATING DISORDER?

    Binge Eating Disorder is a fairly new "diagnosis" - as with all diagnosis' it takes time, funding, research, man/woman hours to label a behavioral pattern and get it approved and published in the Diagnostic and Statistical Manual (aka my bible in my profession).  This means that BED (Binge Eating Disorder) has existed for a long long time however it is only recently that enough attention, research, money etc. has been invested into it that it now has a name and place in the medical field. 

    The first thing that needs to be said is that we ALL binge eat at times.  Perhaps you haven't eaten all day because you've been chasing kids around town or traveling for work and suddenly you are overcome with hunger and you consume a day's worth of calories in a sitting.  This is a binge to a degree.  This is not a disorder.  What classifies anything as a disorder is two things 1) frequency/recurrence  2) distress/stress.  If there is a repeated pattern and if that pattern causes you and your life distress this is when we begin to look at this particular behavior as a disorder. 

    In my 80/20 program, one of the first group sessions is entirely focused on our relationship to food.  Like ANYTHING else, food can become an addiction.  In the DSM V, BED is categorized under "Eating Disorders" but I will tell you from my research and time with clients, I think this categorization is incorrect.  I believe BED belongs under "Addiction".  BED is a very chemical/neurologically driven disorder.  It's not a character flaw or a moral ineptitude.  It's not about "choice" because if that were the case NONE of us would ever "choose" to be addicted to anything!  DUH! 

    Addiction (and specifically BED) is about a need for connection.  Human beings are not meant to operate in isolation.  And when we are feeling isolated, disconnected, stressed, shameful, afraid, we will naturally reach for connection.  If there is no adaptive connection already in place (i.e. a partner, parent, mentor, loved one) we will reach for ANYTHING to soothe ourselves, to decompress, to unwind the horrible agony of disconnection.  Some people are more hard wired to reach for alcohol.  Some for gambling.  Some for shopping.  Some for food.  Some for ALL of the above. 

    Food addiction in my opinion begins young.  In our country particularly it is easier than EVER to become addicted to anything, most especially food.  When you begin at a young age feeding on high glucose foods your brain makes an adjustment.  It begins to associate comfort, base level "okay" ness with glucose and then add to this any sort of trauma, pain, difficult life experience where there was no human connection available but there was cake/cookies/pizza/donuts your brain makes an even bigger adjustment.  It has now solidified a connection between glucose and emotion regulation.  Multiply that by the years old you are and that my dears is why is so dang hard to "disconnect" with food and "reconnect" with other more healthy, adaptive coping mechanisms such as relationships, yoga, journaling, exercise. 

    Some of my 80/20 group members have suggested that I offer the program to individuals without the group element.  This they told me would be helpful to those particularly struggling with shame and embarrassment.  Then they wouldn't have to face a group and deal with the discomfort.  I have sat with this for some time now.  Our society likes "individual" sessions of any kind.  Don't we?  And I believe in their power to a certain degree.  I see her point and if I just wanted to make a profit only, I could market myself and my program in this way.  But that isn't my goal.  My goal is to help people.  To effect change.  Change in you.  Change in your body.  Change in your system.  This, despite how desperately I wish I could tell you the opposite, requires DISCOMFORT.  The only way through something like BED is to get really really uncomfortable with a trusted, safe person/s and to go through it, not around it.  If, and I believe this with all of my heart, BED is about a loss of connection, then we must have a group to be connected with in order to have a radically different experience.  I saw this happen with my first 80/20 group.  They made connection. 

    Binge Eating Disorder is defined as :
    "recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control.  Someone with BED may eat too quickly, even when he/she is not hungry.  The person may have feelings of guilt, embarrassment, or disgust and may binge eat alone to hide the behavior.  This behavior causes distress and occurs at least once a week over at least a three month period."

    If you think you may be struggling with this disorder, reach out.  You, my dears, are not alone. 

    Be curious.  Be brave.  Be you.
  • Do NO THING

    As I was eating my dinner this evening and catching up on some news from the week I came across an interview with Victoria Azarenka in the Wall Street Journal.  For those of you unfamiliar with Azarenka - she's a fierce tennis pro and is famous for her loud shrieks (not unlike Serena Williams).  I'm a tennis fan.  Former player.  But the point of the article and my point herein sending this email to all of you can be summarized by the title of the article itself: Victoria Azarenka Learns to Chill Out.

    Azarenka struggled with some major injuries last season which prevented her from winning grand slams she was expected to secure.  Instead 2015 was a year of disappointment to say the least.  The tennis star was seriously depressed.   

    "Before  Azarenka began to train for this year's Australian Open, she engaged in a few months of re-programming.  She adjusted the way she pushed off on her left foot, which had long caused her pain.  With the help of a specialist she changed the way she moved her jaw with lots of practice in front of a mirror to give it more range of motion and to help align her spine.  She conquered her fear of needles so she could try acupuncture.  And then there was the most important challenge of all, something the hyperactive Azarenka had always been too afraid even to attempt: she learned how to sit around by herself and do nothing."

    One of the theories of change I submit to in my own practice, and in my work with clients, is mindfulness, and following something known in Buddhist psychology as "the middle way".  This, Buddhists believe, is the cure for all of life's ailments.  To hold nothing too close or tightly and to push nothing too far away too quickly.  No grasping, no forcing, no fighting.  We are just     "to be". 

    How many of you have filled your schedules to the point of exhaustion?  How many of you are truly ever able to "rest"?  Is resting scary?  Does it feel "wrong"?  Do you experience guilt when you say "no" to someone, or something?  Do you fear that if you give yourself time and space you will "go backwards"?  Do you fill the silence with food?  With alcohol?  With mindless television?  With shopping?  With smoking? 

    I had a client a few weeks ago come into my office and tell me that she just can't take it anymore - she can't take having free time because it reminds her of how alone she is - so she fills it - she has been filling it for so long that her adrenals have about run dry and she is physically weak and limited in her ability to experience pleasure or glee or delight unless she is with another person, doing something, pushing herself towards accomplishing something. 

    This, I told her, was the glorification of "busy" and a means of coping with difficult feelings about her identity, her self-worth, her life choices.  She didn't want to have peace and quiet because she didn't want to have to sit with herself.  Silence can be scary.

    Azarenka is an example of someone who literally ran themselves dry.  Injury forced her to sit with herself and she's lucky it didn't cost her entire career.  She is back in full force this season - slated to win several grand slams - and she credits her work around doing "nothing". 

    Biologically we are still the animals we once were back in the days of cavemen and cavewomen.  This means that during times of heightened attention, hyperaroused states, our bodies act to conserve and preserve.  The ring many women ( and men!) have around their midline is more likely the end result of STRESS.  It's fat stored away for survival. 

    Along with your attention to diet and exercise during these 8 weeks, perhaps you also might take a look at how you cope with silence?  How often do you sit with yourself?  How do you avoid it?  What's holding you back from self-acceptance, self-care, your relationship within yourself?  What wisdom are you missing out on because of your fear of less activity, less fuss, less "busy"? 

    From Tibetan literature:

    "Remember your radiant true nature, the essence of mind.  Trust it.  Return to it.  It is home."
    ~ Namaste