The Mind Body Connection

I am exited to introduce you to my new affiliate Andy Schmalz at Awakening Heath in Burlington. Andy Schmalz is an osteopathic manual practitioner and certified athletic therapist with 15 years of clinical experience. He is extremely skilled and heart-centred. He treats each client with compassion, wisdom and respect. He synthesizes concepts in energy medicine, nutrition, and environmental influences with traditional therapeutic concepts to provide a thorough rehabilitation to fit each person’s unique needs. I would like to present him to you by sharing one of his articles.

Over the last few years, I have repeatedly written about the mind body connection and how a physical issue has messages for us in regards to our emotional and mental well-being. Some typical examples are headaches, indigestion or physical pain in different areas of our body, or even a simple cold. Andy’s article is filled with excellent examples of how treatment has to address the whole human being.

Read Andy Schmalz’ article below

and/or join us for a 30 minute podcast episode about

the interconnection of physical issues with emotional and mental ones.

 

The Mind Body Connection

BY ANDY SCHMALZ, DO(MP), CAT(C)

We are often taught that the different issues in our body are the result of physical, emotional, or mental stresses. For physical injuries we look to some sort of therapist that focuses on stretching and strengthening to bring the physical structure back into a balance. Mental and emotional issues are treated with a therapist that has been trained in talk therapy and various rehabilitation techniques to help heal the initial trauma. The compartmentalization of these conditions has created a roadblock to healing for many individuals.

Instead of thinking of physical, emotional and mental health as being separate, they should be viewed as interrelated aspects along the same continuum. This can be thought of as similar to colours on the spectrum. Red, blue, yellow, or any other colour are not individual spectrums on their own colour palate, they are part of the same spectrum that transitions through all colours. In the same way that the inclusion of all colours combined produces white light, the total combination of physical, emotional, and mental spheres is required to produce holistic health.

To introduce this concept, let’s look at a simple injury like a sprained ankle. Imagine you’re a high school athlete competing for your school’s basketball team in the playoffs. You accidentally land on someone’s foot when descending from a jump and roll your ankle. You feel a couple of pops, a lot of pain right away and know it’s not good. You later discover that you will have to miss 4-6 weeks in rehabilitation if everything goes according to plan.

This is a very mechanical issue, right? There was no emotional stress that caused you to hurt your ankle so it should be a straight forward rehabilitation – manage the inflammation, begin range of motion exercise, slowly re-build the strength and continue from there. 4-6 weeks, right on schedule. But let’s take a look a little more closely at the whole scenario.

No injury is ever purely physical or purely emotional. They are opposite ends of the same spectrum. When you rolled your ankle, what were your feeling before and after the injury? You’re one of the better players on the team and there’s likely a feeling of letting your friends down, or possibly frustration because you had prepared hard for this year and now you’re going to miss the end of a short season. Maybe your coach isn’t supportive of the situation. Instead of reacting with empathy he/she responds with frustration that they have now lost one of their starters and the team’s chances of winning the championship have taken a hit. You will be able to feel that pressure during your healing process. And these thoughts don’t even include what might be happening at home – maybe your parents have been fighting lately and it has begun to create a lot of stress in your life. Maybe you’re having relationship issues with your boyfriend/girlfriend. Maybe there’s a loved one like a grandparent whose health is deteriorating.

The point is that ALL of these different stresses and emotions come into play during your healing process. Once again, the physical and emotional domains are opposite ends of the spectrum, and it’s important to have a rough idea where this injury falls within the spectrum to determine what type of treatment is required. This is not to say that every injury you experience needs to be assessed by a trained psychotherapist. Having a rough idea where an individual is in the spectrum helps to identify any barriers to healing as well as guide treatment. In this simple example of an ankle sprain it’s likely that the injury is much closer to the physical end of the spectrum with a small emotional component:

PHYSICAL___X_________________________EMOTIONAL

But if there are significant stressors at home or school, the spectrum would adjust:

PHYSICAL______________X______________EMOTIONAL

The difference between the two spectrums dictates what needs to be addressed in treatment. The physical rehabilitation of the injury does not change – control inflammation, then increase strength and range of motion as appropriate. But it’s possible the athlete in this scenario is carrying some stress that can slow the healing of the ankle. It may still heal on its own but the process will be more complete – and the care for the injured individual much more comprehensive – if the emotional stresses are identified and addressed. While this example is hypothetical, it’s well within the realm of possibility. Let’s look at a couple examples from clinic.

Example 1

A pre-teen girl (age 11) comes into clinic complaining of neck pain and headaches. Upon assessment the typical issues leading to neck pain are present – tension in the deep muscles of the neck, a change in breathing pattern (chest breathing), increased tension in the connective tissues of the abdomen, and weakness in the muscles of the mid back. The simple formula is to reverse these findings and the headaches should alleviate. However, in conversation during treatment the patient reveals that she has been experiencing difficulty all year long with a bully on the school bus that has been progressively getting worse. Her parents are aware of the issue but have not been fully informed about the severity and the young girl has not been forthcoming about the impact it is having on her. This simple disclosure has a significant impact on the healing process. The stress of worrying about a bully on a daily basis will create the tension in the abdomen (see effects of inflammation), change breathing patterns, and likely create the tension in the muscles of the neck as well. The approach to treatment at this point needs to change. The physical symptoms will resolve with the treatment of physical restrictions, but will return if the initial root issue is not addressed. The impact of the stress on the patient needs to be brought to his parent’s attention so they can address the issue appropriately – or the time and energy spent on neck rehabilitation will likely be redundant.

Example 2

Many of us carry low-level stress on a constant basis. We have simply been doing it for so long that we do not realize that it is actually affecting us. But the physiological effects of inflammation and the blood flow changes associated with stress can take a significant toll on us that we do not realize until there is a breakdown in the physical body. In this example you are a parent working full time with a couple of kids. You try to take care of your body but your responsibilities to your children take up much of your time. You are so tired at the end of each day that you can barely make it up to bed. Instead, you pass out on the couch most nights. You do get out for walks with the kids and eat the best you can, but the busy-ness of young children consumes most of your life…soccer practices, music lessons, birthdays, family commitments, etc. Sound familiar?

Life flies by, work gets busier and responsibilities increase. The kids are older but there are some minor troubles at school that worry you. Your parents have started to experience some health difficulties and need some help at home. Each of these commitments has also placed a strain on your marriage that simply wasn’t there 10 years ago.

Then one day you pick up your daughter after a particularly bad day at work – the same way you do every day when you get home from work. She’s only 45 pounds and you have lifted her many times before. But this time your back spasms and you experience extreme pain that brings you to your knees. You immediately know you’ve “blown out your back” and are able to see your doctor the next day. You’re told it’s a muscle strain and that you didn’t lift properly and that’s why you’ve hurt your back. NO WAY!!

Let’s take a close look at what has actually happened. Years of wear and tear and progressive increase in stress have decreased the mobility of your body. The lack of flexibility has finally reached a point where your spine cannot accommodate the things you’ve always been able to do, like pick up your daughter. The bad day at work is the proverbial straw that breaks the camel’s back. Your system was at a point where it could no longer accommodate any more change. The small change in blood flow to the muscles due to the cumulative stresses combined with one more stress lead to the muscle spasms.

What does this mean for your treatment? The back will likely heal no matter where you do your rehabilitation. If it’s really bad you might need to try a couple different practitioners before you feel back to normal. Stretch the muscles of the low back, release the tight connective tissues on the abdomen, strengthen the core, and things should resolve in a typical fashion. But here’s the problem – you have done nothing to address the root causes of the back injury. You have approached your rehabilitation as a purely physical phenomenon and therefore you have not completed your rehabilitation. Unfortunately, you will likely injure your back again in time.

What else could you do to completely heal your injured back? You can’t necessarily control the events in life that cause your stress, but you can manage how you react to stress using appropriate techniques. Managing stress is a multifactorial approach (view Andy Schmalz’ article “Managing Your Stress”) that should be part of our everyday lives. If there is a significant strain on you personally because of your parent’s health or relationship you may benefit from talking to a trained psychotherapist that would compliment the physical side of your rehabilitation. Meditation, breathing techniques, regular physical exercise, yoga/flexibility work and potential modifications to your diet all come into play when trying to heal something fully instead of simply managing symptoms for another couple of years.

Example 3

It is important to remember that the physical and emotional connection is a two-way street. The first two examples showed how emotional stresses can either create an injury or slow it’s healing. But issues that seem to be purely emotional can also create a physical imprint. Anxiety is a perfect example. Anxiety is like a little breeze that can quickly turn into a tornado that takes over your brain and body. The emotion is often created by a perception based on a root fear that leads to worry and distress. And like many things in the brain, the more it is experienced the easier it seems to become to trigger an anxiety attack. But what we forget is that there is a physical imprint left in the body that seems to form a physical pattern – and once that pattern is established it feeds into the continued development of anxiety. In essence the physical imprint helps to perpetuate and lower the body’s threshold for anxiety.

When we experience anxiety, breathing patterns change – the breath becomes shorter and we no longer activate the thoracic diaphragm to breathe properly. Instead we use the upper chest muscles and neck muscles attaching to the upper ribs to lift the ribcage and create the breath. This results in increased tension in the thoracic diaphragm, neck and upper back that may affect nerve and blood supply to the head potentially creating headaches. There also seems to be a consistent pattern of tension in the centre of the upper abdomen just below the ribs that can lead to abdominal discomfort. It may be the inflammation in the body from the anxiety or some sort of other pathway but some of the stress from anxiety collects in this solar plexus area that seems to make the emotion of anxiety easier to experience.

As these physical changes culminate, they restrict proper breathing and seem to feed into the development of subsequent attacks. Releasing the physical imprints of the anxiety attacks seems to help the body manage anxiety. It is important to note that this is in no way a substitution for counseling. Instead it is approaching the body from a holistic point of view. Treating only the brain for anxiety will help to decrease the anxiety attacks one may experience, but it will not reverse the physical effects the attacks have.

As you can see in these examples, a physical injury is never just a physical injury. Conversely, an emotional issue will always have a physical imprint. To heal the body, mind and spirit a multi-faceted approach is required. It is up to you to determine the right formula for your healing, as you are the one responsible for your own health. At Awakening Health, our goal is provide you with the information and tools available to achieve the balance in life that we are all seeking.

 

For an Osteopathic appointment go to Awakening Health.

To work on the Emotional and Mental side of a physical issue contact

Belief Change and Relationship Coach Angelika

905-286-9466

greendoorrelaxation@yahoo.ca

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How Relationships Can Help With Anxiety and Depression

I remember how I looked with complete lack of compassion at my mother when I was a young adult in my twenties. I couldn’t understand why she felt to hopeless, helpless and unhappy because I was young and had my entire life still in front of me. In her generation, there wasn’t much to accomplish anymore once your children were grown up. All a woman without a career had to look forward to was the arrival of her grandchildren. And when her first grandchild came, her oldest daughter (me) even lived far away in a different country on a different continent. Looking back now, I realize how once she was over 60, she desperately tried to find meaning as a homemaker with grown-up kids, even though she didn’t take any pride in any of the housewifely activities. She was the happiest when she could go out, connect with people and exercise.

When interacting with her, she usually seemed needy and clingy to me because I wasn’t in touch with my own neediness. I judged her for self-medicating with alcohol and over-exercising because I didn’t understand how we all use STERBS (Short Term Energy Relieving Behaviours) to distract ourselves from our pain. She had depression and anxiety, even though it wasn’t called anxiety back then. I just perceived her as ridiculously worried about things and unnecessarily afraid. My dad, a typical male of his generation, was overidentified with the rational mind and ridiculed her emotions and fears. And my sister and I kept her at arms length when she started getting too anxious. She had nobody to turn to who made her feel a bit safer, a bit more loved. Not until many years later when I was an adult myself with two daughters did that understanding and compassion for how hard it must have been to be her slowly set in.

Today depression and anxiety have become an epidemic. Some experts, for example the Cognitive Behaviour Therapists, suggest depression and anxiety need to be managed by interventions at the level of thought; other experts suggest there is a problem with our emotions. I believe we need to address both, our thoughts and the underlying beliefs as well as our emotions. The changes we make and the techniques we can learn need to consider both. But how do our relationships play into our thoughts and emotions?

From an attachment standpoint, part of the reason for anxiety and depression is a lack of connection. We are mammals who need to bond and connect with others in their lives. My mom was reaching out to a husband who did not know what to do with emotions and to two daughters who didn’t know that she was mirroring certain traits for us that we had disowned inside ourselves. The relationships in our life either help us to manage the depression and anxiety or they trigger it even further.

Partners who are not securely attached to one another, are typically highly anxious and/or depressed. We relive our childhood fears and experiences with our partner. Our partner is a proxy for all the other relationships we have ever had, going all the way back to our first attachment figures, our mother and father.

When we want to address depression and anxiety, we need to grow resources within ourselves, but relationships themselves can also become a resource and a safe heaven to find release. According to attachment theorist John Bowlby, people who feel depressed are experiencing an inner narrative about feeling lonely and not seeing themselves as important to other people. Sue Johnson points out that in our primary relationship, this plays out as the experience of not being seen, not mattering and not being needed. The emotions triggered are those of feeling unlovable and unworthy, of not being good enough in relation to other people.

So from the view of an attachment theory based clinician like Sue Johnson or Stan Tatkin, the cure for depression and anxiety lies in healing the loss of connection that was experienced in earlier relationships, which is being mirrored in our present relationships. Tatkin points out the effectiveness of face-to-face and eye-to-eye contact between partners. That connection through the eyes is stimulating and can upregulate the partner who feels depressed or anxious. It also focuses the depressed person outwards, instead of in their own head. It is like an outside meditation, keeping the focus on the present moment instead of the painful past or the worries about the future that are playing out in a depressed or anxious mind.

The importance of the eye-to-eye connection has been studied on mothers and infants. The more the mother makes contact face to face, giving the baby reassuring facial cues and being attentive, the more secure and happy the baby feels. The still face experiments with babies (for example conducted by Dr. Edward Tronick) on the other hand have shown that a still face in the mother and a lack of connection through visual and auditory responses create a response of fear and anxiety in the child.

The same still applies to adults. We are social mammals. There is a tremendous power when two people allow themselves to be truly present in and dedicated to a relationship. All our past relationships come out through the present-day love relationship to be completed and healed. Initially, the anxiety and depression might be intensified in the interactions, but partners can learn how to help co-regulate each other’s emotional states. According to Tatkin, the partner can become the best antidepressant and anxiolytic.

Tatkin points out the importance of “landing together at night and launching together in the morning”. Ideally, we start the day with our partner and we end it again in the evening by sharing about the day and connecting. He states that co-sleeping creates an important connection, even though that requires that issues like intense snoring, sleep apnea and restless-leg syndrome are being treated successfully.

In order to hold each other and down-regulate together, it is useful to have a tool to rate and communicate the emotion(s) that come up. Jayson Gaddis’ NESTR ritual would be one such tool. The N stands for the Number of activation. 1 is not triggered at all and 10 would be extremely activated, for example feeling high anxiety. The E is to pinpoint the Emotion that we are experiencing. The S calls to find the sensation in the body which comes with this emotion. And T is for becoming aware of the Thoughts or the inner narrative that goes hand in hand with the emotion. R is a reminder for Resources that the individual can connect with to either regulate themselves or regulate together with the partner.

There is a lot of advice out there on the internet on how to love someone with depression and how to love someone with anxiety. There are of course many different degrees of depression and anxiety disorder, and differing responses are required. Often both issues come hand in hand. The numbness of depression can be a protective mechanism so that we do not need to feel more frightening emotions.

A few things you can do for your partner or another person close to you to deal with mild anxiety or mild depression are to truly listen, acknowledge, empathize and normalize. Your partner needs to know that you care and that what they are experiencing is understandable and normal. Do your best to be patient. Fears may be illogical but they are still very real to the person. Encourage your partner and lift them up. Tell them why they matter to you. Whatever you say or do, keep in mind that your only goal is to make them feel safer and more loved. Arguing about right or wrong makes no sense when fears are involved.

When your partner finds the courage to express an emotion, validate it with your words, your tone of voice and with simple actions. You can ask if they want a hug or if they want to be held. If something you do makes them feel anxious, adapt. If you are, for example, triggering an anxious response in your partner because you drive faster than they do, respond by saying, “I am sorry, honey” and slow down. This is not about you and if you are a good driver, this is about an irrational fear that your partner is experiencing. You can either choose to get defensive and be right or you can be a partner they feel safe with.

Or if your partner has a hard time getting out of bed and finding meaning in life, don’t judge or ridicule, don’t preach about how good their life is or become a fixer or pusher. Gently encourage. Small steps of doing something different are huge leaps forward when dealing with depression. Imagine your partner just had surgery. You wouldn’t push them to leave the hospital and be fully recovered the day after. Just slowly walking down the hallway on your arm would be a huge accomplishment for them. It is the same when recovering from depression. Small changes every day are progress. Provide companionship as your partner establishes healthy habits and rituals of movement.

For both anxiety as well as depression, be present and be in your heart. If you feel judgment like I used to feel for my mother, it’s because your own shadows are triggered and that is where the work needs to be done.

Contact me for more information on either couple’s coaching or individual sessions. We can work on your own triggers and patterns in individual sessions or on your interactions with each other, so you can be a relief to each other when anxiety or depression show up.

Angelika

905-286-9466

greendoorrelaxation@yahoo.ca

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Hello, Old Pal Anxiety!

Listen to this blog as a podcast here, or read it below!

Ingrid has colitis and other health challenges; the unpredictability of her physical issues gives her anxiety. Margaret has a fear of flying which has gotten progressively worse; due to her anxiety she has not stepped foot on a plane in years. Peter is a widower and single dad with three daughters; the oldest one has anorexia and he is experiencing great anxiety regarding her well-being, as well as her sister’s. The two teenagers are both plagued by anxiety as well.

Anxiety is a more and more prevailing challenge for many people. One in five Canadians has a mild to severe mood or anxiety disorder. Anxiety is especially on the rise among children and teens. It is a continuously growing concern at any age. What is happening in our brains and how can we address this issue?

To understand how our brains function, we need to remember that for our ancestors, negative experiences had more impact for their survival than positive ones. They needed to remember their painful or dangerous experiences so they would not repeat them, in order to survive. Our brain is still wired that way. Our brains evolved with a “negativity bias” (Rick Hansen). In general, we remember negative experiences more easily, unless we really focus on the positive ones and take them in deeply. That is like a “learning disability” and traps us in conflict. So, it does not help at all to tell somebody who is worrying or has anxiety to think positively.

Anxiety - time

The experience of uncertainty which creates anxiety comes from the fact that we can make representations of time. We structure our experiences into past, present and future. The ability to analyze the past and think ahead to the future is part of the human survival kit. We are supposed to learn from the past, be very awake and alert in the present and make sure we are safe in the future. Unfortunately, our ability to evaluate future risks is only based on a few facts and our left brain fills the gaps between those facts in with a story. Depending on which subconscious beliefs we have about ourselves and the world, this story our left brain makes up is either a supportive one or a limiting and fear-inducing one. In the case of anxiety, our left brain has created a fear narrative.

Mark Twain says it humorously:Anxiety - Mark Twain

Most thoughts that makes us anxious are thoughts about the future, a future that generally never happens like we imagine. That is why mindfulness and staying in the present moment helps to train the brain to stay focused on the here and now. The present is all that is real. Therefore, mindfulness alone can already help with anxiety.

We have also been trained to avoid unpleasant emotions, to push them down and not feel them. So naturally, we don’t want to feel anxiety. However, our attempt to push unpleasant feelings down, keeps the anxiety going. The attempt to make anxiety go away is what traps us in it, not the anxiety itself. Instead of putting all our energy towards avoiding the anxiety and trying to get rid of it, we can learn to be with it and ride it out.

It is an ancient Buddhist practice to stay with the feeling that arises. So when fear or dread arises, we can welcome it into our heart and stay with it until it has moved through us. Greet the anxiety like an old friend, “Hello, my friend. I know you. You are my old pal fear. Welcome back.” Then keep breathing all the way into your belly, long deep and complete breaths, letting your belly expand on the inhale, and become smaller on the exhale. Simply being with the fear allows it to come and go like all other mental content.

meditation-monk

Of course, mindfulness and being with the feeling requires practice, like everything else in life. When we say, “I have tried that mindfulness thing, it doesn’t work” it’s like saying “I have tried playing the piano, it does not work”.

Often we believe uncertainty is the problem to be solved. “If I could just control my physical body”, or “If I could just have the guarantee that there will be no turbulence”, or “If I just knew whether I will pass my exam or not”, or “If I just knew that my child will be alright in the future”.

Uncertainty is not a problem to solve. A much more useful approach is to rest in the uncertainty and experience it as a sanctuary of possibilities. When we are emotionally in a place to create a positive influence or make choices, we end up being more comfortable with the uncertainty of a situation and, in the end, are more in control.

A situation of suffering and uncertainty can challenge our whole identity. Being sick might challenge my identity to be a productive and capable human. A fear or phobia might challenge my identity as a rational adult or spiritual person. A crisis with my child might challenge my identity as a good parent.

We first of all need to remember that we still are who we always were. In fact, we are everything. We are capable and rational and spiritual and a good parent. We are just having the experience of a hugely challenging situation. Because it is unpleasant to feel the pain, disappointment, shame, anger, fear or other emotion, we seek control. If we instead acknowledge the painful feelings, we can shift into a place of self-compassion. We can then move from attempting to gain control to choice.

We can always ask “What can I choose? What can I bring to this situation? Courage? Trust? Love? Who do I want to be in this situation? And how do I want to feel?” The answer might be “I want to feel less alone and therefore I reach out for support to address this health crisis” or “I want to be present and calm on the airplane and trust that I am safe in the Universe” or “I want to be compassionate and loving with my struggling child”.

Anxiety - choices

 

If you are enjoying my articles, you can subscribe to receive an e-mail notification whenever I post a new blog. All you need to do is to enter your email address in the field on the left side of the bar. Thank you for your support!

Angelika, Belief Change Coach

905-286-9466, greendoorrelaxation@yahoo.ca

You can also join me on this meditation to ask ourselves

what we can choose in a current anxiety provoking situation: