Bottom’s Up! How Much Water You Actually Need To Be Drinking

Dr. Stephanie Duffey • Jun 15, 2020

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With summer upon us and the outside temp heating up, I thought I’d pop in with this blog post all about drinking water! Do keep in mind that it’s important to stay hydrated all year long (not just during the warmer summer months). Here, I’ll break down everything you need to know—from the important role water plays in keeping you healthy, to tips for meeting your daily intake needs.
 
What’s the deal with water anyways?
 
As crazy as it sounds, did you know that up to 60% of the adult human body is made up of water!? Check out this break down of the water percentages in your body:
  • Brain and heart = 73% water
  • Lungs = 83% water
  • Skin = 64% water
  • Muscles and kidneys = 79% water
  • Bones = 31% water
 
So why does all this matter? 
 
Water not only helps your body stay hydrated, but it also keeps your muscles and joints lubricated for maximum efficiency. Water is beneficial to other systems too because it:
  • Regulates our internal body temperature by sweating and respiration
  • Helps transport oxygen all over the body for a healthy heart
  • Assists in flushing waste and preventing constipation
  • Acts as a shock absorber for the brain and spinal cord
  • Forms saliva and aids in digestion
 
How much water should I actually be drinking?
 
Now, to answer the question you’ve all been waiting for! How much water should you be consuming on a daily basis? The amount varies per person but the easiest way to think about it is to aim for half your weight in ounces of water.
 
So let’s say you weigh 150lbs. Your water intake should be right around 75oz. Another factor to pay attention to is activity level. If you exercise often and sweat a lot, you’ll want to consume even more water to replenish yourself. You can perform a sweat test before and after exercise to see how much you’ve lost through perspiration. For every pound you lose, that’s an extra pint of water you need to drink.
 
Tips for getting your H20:
  • Sip your water throughout the day rather than chugging it all at once and always keep a bottle with you (Hint: If you’re thirsty you’re already dehydrated).
  • Use water as your main source of hydration (Drinks that are high in sugar or caffeine can actually dehydrate you).
  • Check the color of your urine (It should be pale and clear rather than dark and odorous).
  • Try infusing fruit into your water for a fun and refreshing flavor.
  • Incorporate liquid-based fruits like grapes and watermelon into your diet (these provide hydration too!)
 
​I hope you found this post to be helpful. Questions or comments? I’d love to chat with you!

8 Tips For Tight Hamstrings

Stephanie Duffey • Jul 06, 2020

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As a physical therapist, I hear complaints all the time related to tight hamstrings. In fact, the hamstrings get a bad rap for always being the problem muscle, but if we take a closer look, you’ll find that your hamstring tightness may just be a symptom of another issue. Here, I’ll break down my top 8 tips for relieving tight hamstrings and preventing future pain in this muscle group.
 
1. Don’t be a sloucher. 
Poor posture can be a huge contributing factor for hamstring tightness. When you arch your back, you’re actually putting more strain on your hamstrings to help hold you in that position. Instead, focus on stacking your ribs over your pelvis. Your hamstrings will thank you!
 
2. Be a belly breather.
Being a belly breather goes hand in hand with keeping good posture. When you stand properly, your diaphragm works more effectively, enabling you to breathe better while creating stability and activation through the core. 
 
3. Keep your core strong.
When you stay mindful of your posture and breathe through your belly, you’re activating your core. In addition to following tips 1 and 2, it’s also important to specifically target the core as a muscle group. Tight hamstrings could be compensating for a weak core, so make core part of your weekly training routine. Here are some of my favorite exercises to work those abs (Plus bonus side effect: You’ll look great in your swimsuit!)
 
4. Keep your glutes strong.
Remember in tip 3 when I said that your hamstrings could be compensating for a weak core? The same is true with your glutes. The more you train the glutes and core, the better off your hamstrings will be. So share the love with other muscles groups. Download my Runner’s Prehab Guide for some of my favorite moves for strong glutes. (These are great exercises even if you don’t run!)
 
5. Don’t be a “sitter.”
This one’s for all my peeps with desk jobs. When you sit all day, you put your hamstrings in a shorter, tightened position. Take advantage of this quarantine and break up your day by going for short walks so you don’t get stiff. It’s also a great way to take a mental break!
 
6. Remember the hammies in your strength routine.
Fun fact, tight muscles do NOT always equal strong muscles. If your hamstrings are tight, it could actually be a sign that you need to strengthen them. Try some of these moves for strong hamstrings.
 
7. Practice dynamic stretching before a workout
You’ve probably heard this before but it’s incredibly important to move while you stretch to prevent cramping and better protect your muscles. Try walking hips swings or some of these exercises to set yourself up for success before your workout.
 
8. Foam roll after a workout.
One of the best ways to release knots and trigger points is foam rolling. It’s an awesome recovery for your muscles after a run or workout and provides a deep release while preventing muscle tension and pain. Do your muscles a favor and show them some love after you make them work! Here’s my favorite foam roller.
 
Need help treating your tight hamstrings? Let’s chat!

PRACTICE, PRACTICE, PRACTICE *

Paul Linden, PhD

Aikido of Columbus

www.being-in-movement.com

I have been practicing Aikido since 1969 and Parkinson’s Disease since 2004. Aikido is a non-violent Japanese martial art and a study of peacemaking. Parkinson’s is a degenerative disease of the brain. The two have a lot in common.

Many years ago, while visiting Los Angeles, I met a friend of a friend. As we were sitting together eating lunch, he casually said, “You know, I could kill you as you sit there.” I smiled and said, “Yes, of course you could” and kept eating. I knew he wasn’t being hostile but was merely expressing a fact. Astonished that I understood, he explained that he was a Viet Nam veteran, and that was his way of testing me.

He had killed many people, and he knew how thin the line is between life and death. He knew that anyone could die at any moment. Combat soldiers learned to live on the edge of life and death, and when they came home, they were unable to fit back into normal society, which pretends that death won’t happen. He was stunned that a non-veteran knew that edge. I told him about my martial arts training and how it was possible to know the edge without killing anyone.

Two concepts underlie Aikido as I practice and teach it: First, emotions and attitudes are physiological events in the body, and to receive an attacker in a peaceful way, the body must be trained to do so. And second, the body moves with better balance and strength in a state of inner stillness, kindness, and gratitude. (My website has a free downloadable handout titled EMBODIED PEACEMAKING which details the basic exercises that I use to teach this.)


• Copyright Columbus Dispatch 2013. The newspaper published this essay, and they were generous enough to allow me to use it in my teaching.


Practicing calmness when attacked and compassion for the attacker caries over to stresses and problems that aren’t attacks. Such as Parkinson’s, for instance. When I was diagnosed, my initial reaction was shock! And my practice for the next six months was to say to myself many times a day “Parkinson’s” and train my body to go into calmness instead of fear. Gradually stillness and compassion took the unease out of the disease.

The real function of martial arts, I think, is to help us accept our fundamental weakness. I can block a punch, I can parry a kick, and I can escape an arm lock. But I can’t control the weather, a presidential election, or whether I have Parkinson’s. Once we build up enough personal power, we can accept somewhat calmly the unacceptable.

Having Parkinson’s is inconvenient, but if I get frustrated or irritated at it, the tremors increase and the disease feels worse. The more I meet Parkinson’s with an attitude of compassionate engagement and relaxed strength, the better my body functions. This is not philosophy. It’s physiology.

The questions are: What do I choose to become as Parkinson’s eats away at my brain? Do I cultivate habits of fear or anger about my condition or habits of power and compassion? So in the end, practicing Parkinson’s is very similar to practicing Aikido.

Parkinson’s will never be popular as a path of self-improvement. The same approach, though, can be applied to everyday difficulties — whether personal, interpersonal or international. The world would be very different if people didn’t respond to difficulties in a rush of fear and anger. Think of all the killing and aggression that would not take place if we each took responsibility for our body and our hurtful reflexes. Peace would be possible.

—————————–

PAUL LINDEN, Ph.D. is a specialist in body awareness education, and his work focuses on the interplay between self-exploration and more efficient and effective action. He has extensive experience teaching people such as musicians, athletes, pregnant women, children with attention disorders, and computer users. Two of his focus areas are abuse recovery and peacemaking.

He is the developer of Being In Movement® mindbody education, and founder of the Columbus Center for Movement Studies. He holds a Ph.D. in Physical Education, a sixth degree black belt in Aikido and a first degree black belt in Karate, and he is an instructor of the Feldenkrais Method® of somatic education.

He is the author of a number of e-books, and videos, among which are:

• Winning is Healing: Body Awareness and Empowerment for Abuse Survivors

• Embodied Peacemaking: Body Awareness, Self-Regulation and Conflict Resolution

• Feeling Aikido: Body Awareness Training as a Foundation for Aikido Practice

• Comfort at Your Computer: Body Awareness Training for Pain-Free Computer Use (a paper book)

* Embodying Power And Love: Body Awareness & Self-Regulation 10 hour video.

Embodied Peacemaking Process- Five Quick and Easy Exercises

Paul Linden, PhD

PaulLinden@aol.com • www.being-in-movement.com

Love without power is ineffective.
Power without love is brutality.

Conflict is commonly approached as mental, emotional, spiritual, political,  cultural and historical in nature. However, the body’s responses are crucial and are often ignored. Self-regulation on the body level must be a part of the peace process.

The five exercises detailed below are based on my 49 years of practice of Aikido  (a nonviolent Japanese martial art) and body awareness work. The five are the simplest, easiest and most broadly useful exercises I have developed (my books and videos describe many more). The exercises are concrete, specific, and reliable. They are not philosophy. They are physiology.

They are simple enough that people can learn them easily and even teach them to others right away. Applying the exercises in conflict resolution and peacemaking is simple enough that people can use them effectively right away.

MOVEMENT RIDDLES
As a preparation for the five exercises, I use thePicture1following movement riddles to grab people’s attention and get across some key concepts. I have a student stand in a strong forward-stride stance, and I explain that I want him to resist me when I push on his shoulders. I ask whether the person has any physical or psychological issues which would make that unsafe. I ask him to lean into me a bit and make it very hard for me to move him. The demonstration is much more startling when I work with somebody much bigger and stronger than I. Then I ask the client to raise his eyebrows, and immediately I can easily push him toward his rear. Why? The answer is very simple. Raising the eyebrows is part of the fear/startle reflex, and another part is leaning back to get away from the object of fear. When one part of the startle response is done in the body, the rest of the response fires off too – even though there’s nothing to be afraid of.

Another riddle: The student stands in the same stance as before, resisting my push on his shoulders. This time I have the person say something friendly to me and note what happens in his body. Usually there is no effect. Then I have him say something unfriendly and insulting. Almost always the immediate effect of saying something negative is that I can push him back fairly easily. Why? The body responds to unfriendliness and unkindness by contracting, and that interferes with fluid use of the body to achieve effective balance and movement.

A third riddle: Many people use anger as a source of power. Push on the student’s shoulders as in the second riddle. But this time have the student think of something that makes him angry. See whether that creates more stability and strength or less. Most people will experience less balance and less strength when they are angry as compared to when they are calm and kind.

A fourth riddle: Stand in front of a student and grasp his wrist. Now pull him toward you. The student’s task is to not be pulled toward you. Most people brace their posture and resist the pull. That is, of course, one strategy for succeeding at doing what was asked for. However, that strategy, though effective, takes a lot of hard work. I suggest that they simply walk forward. People realize that they understood the instruction to mean “Don’t move forward.” However , the instruction actually was to not be PULLED forward, and the easiest way to do this is to walk forward—and take over the movement. This riddle is about taking a different perspective and how that opens up new options for dealing with difficult situations.

I have found a number of somatic riddles, and they all hinge on taking a different perspective in some fashion. The point is that the body is where peace can be observed and practiced in a clear and concrete way, if you have the tools. These three riddles point to the fact mind and body are the same thing. And they also point to the fact that the optimal way of functioning is based on the integration of power and love.

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DISTRESS RESPONSE
Emotions are physical actions in the body. Feelings are what those actions “taste” like to the person who is doing them.When we are threatened or challenged or hurt, we contract or collapse our posture, breathing, and attention— as the picture of the woman being touched shows. That is the distress response, and it is usually experienced as feelings such as fear, anger, helplessness or numbness.

These powerful physical responses hijack the rational mind and compassionate heart and move our thinking and acting toward oppositional and violent ways of dealing with the challenges we face. Being hurt or hurting someone often leads to dehumanization of the other person and of oneself too, and out of this comes more prejudice and more distress.

When the distress response gets locked into the body, that is the trauma state. You should be aware that in any group of 25 people or so, there are likely to be 1 or 2 survivors of child abuse or other trauma, and body awareness exercises sometimes can throw people into painful emotional states that they had been suppressing. These five peacemaking exercises are also effective for empowerment in trauma recovery work. However, working with trauma is more delicate and requires broader skills and understanding. If someone drops into trauma recall as you teach embodied peacemaking, keep breathing and stay relaxed and steady, and you will find a way to steady the person. Then refer them to a qualified professional.

FIVE EXERCISES

Just as you cannot dig a hole in the water, you cannot stop doing a particular behavior. Instead, you have to start doing an incompatible and more useful behavior. The opposite of and antidote to the physical state of smallness is a state of centered expansiveness. This state of calm alertness and compassionate power moves our thinking and acting toward empathic, assertive and peaceful ways of handling conflicts. And living in the present with compassionate power breaks the chains that bind people to their past trauma.

RELAXED CORE: Let your tongue hang softly in your mouth. Most people will feel that this relaxes the muscles around the neck and shoulders.

Let your shoulders and your armpits hang loose and notice the effect on the rest of your body. Let your belly plop loose. Let your legs hang on the ground. When you breathe, where is the movement in your body? Up into your chest perhaps? That is fear/startle breathing. As you inhale, let your belly expand. Your chest should also expand as you inhale, and the focus of the breathing movement will be on relaxing/expanding the belly. Most people find this very calming.

SMILING HEART: Everyone has something or someone that makes them happy inside —perhaps a friend, a child, a flower, a piece of music. Stand with your eyes closed, and spend a moment thinking about whatever it is that makes you smile inside. What hap-
pens in your body? Most people experience a softening and warmth in their chest, and a freeing up in their entire body.

Can you use your image while you are in a conflict to keep your body stabilized in the feeling of compassion? That would alter your relationship to your opponent. Can you stay anchored in this feeling even when thinking about difficulties in your life?

SHINING: Imagine that you are a star or a firefly or a light bulb. What do you do? You shine. Feel every inch (or centimeter) of your skin glowing outward, as you shine in every direction—as far out as you wish. How does that feel? Most people experience this as spacious and calm.

Some people find it easier to imagine something tangible to reach their awareness toward. A popular image is that of reaching toward Picture3slices of pizza.

 

 

 

 

 

 

 

 

 

 

Picture4POWER SITTING: Power is necessary to allow
us to function in a loving and peaceful manner. Love without power is weak and ineffective. And of course power without love is brutal and destructive. The development of power starts with postural stability.

Stand in front of a chair, and get ready to sit down – but in a new way. With each hand, touch your hip joints. Not the hip bones – which are the top edge of the pelvis, but the hip joints – which are in the fold where the legs bend. Imagining a line from the hip joints to the tailbone, push your tailbone back and down along that line. This will lean your torso forward, but not too much. It will take you down to a sitting position. This way of sitting down creates a posture that is very strong yet without effort (see the photo). Most people feel calm, alert, and dignified in this posture.

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POWER WALKING: There is a standing equivalent of the sitting posture. Walk around barefoot, pay attention to how your legs and feet make your body move forward across the floor. Many people swing a leg forward, and the weight of the leg drags their body forward. Some people put a foot on the floor out in front of them and then pull themselves forward with it. Some people feel that when their foot is behind them, they push themselves forward with it. Stand with your feet together, and jump up in the air. To jump up, you push down. To walk forward most efficiently, you push to the rear with the back leg. A simple way to experience this is to have a partner grasp your belt from behind you. Your partner should pull back and offer moderate resistance to your walking. You will experience that the only way to move forward is to push backwards with the rear leg. People generally experience that when they walk with this awareness of the down/back thrust of the feet, their walk becomes more erect, clearer and more energetic. It is mechanically more efficient and powerful, and it is also much more psychologically confident and alert.

APPLICATIONS

How would you use this body awareness process in managing a conflict? Identifying the emotions as body actions, you could ask, “Where in my body am I doing something? And what am I doing there?” And once you identify what and where the emotions are, you can manage them and break their hold on you. It will not itself be the solution to the conflict, but it will enable you to think and act more freely and come up with a solution if one is possible.

Body-based self-regulation (Embodied Peacemaking) enables people to control their fear and anger and act in peaceful, healthy ways. Deliberately widening and opening yourself in the midst of conflict allows a cooperative peace process to begin unfolding. If you stay centered, you will not see the other person as an enemy or feel the urge to hurt him/her. Deliberately opening when you want to contract or collapse weakens the physical habits within you and lets you live in a centered strong civilized place. Even though this process often works for people right away, regular practice of somatic centering will make it easier to stay centered when a conflict arises.

If the conflict involves a physical attack, though it is counterintuitive, being kind and generous will free your body so that you can fight more effectively – if fighting is the only choice. In the usual verbal disputes, body-based self-regulation enables people to stay focused on the substance of the dispute and not get distracted by the emotions that are stirred up by the dispute. Beyond that, if you notice that your emotions are hijacking the dispute and preventing calm, respectful dialoging, you could ask for a 5-minute body awareness and breathing break.

THROWING TISSUES: A PRACTICE ATTACK

How can we get a practical handle on what conflict is and what its physical effects are? What we need to begin the investigation is a small piece of violence. If it is safe and small-scale, it will not cause unbearable stress, and it will be safe enough to
study. But it must be real enough to arouse a response in you, or it will be not be worth studying.

Ask your partner to stand about six or eight feet away (about two meters) from you and throw balled up tissues at you. Most people find that this mostly symbolic gesture does arouse some fear, but since the “attack” is minimal, so is the fear.

Calibration is important. The exercise must be matched to the student. In working with people who don’t feel much, it is often necessary to increase the stimulus intensity so that they get a response large enough for them to notice. I might wet the tissue so it hits with a soggy and palpable thud. Or I might throw pillows instead of tissues.

On the other hand, I often have people tell me that even throwing a tissue at them feels too intrusive and violent. In that case, standing back farther so that the tissue doesn’t reach them, makes the “attack” even more minimal. Or it may be necessary to do just the movement of throwing the tissue without a tissue at all. Perhaps turning around and throwing the tissue in the wrong direction will help. Or just talking about throwing a tissue, but not moving to do so at all.

The point is to adjust the intensity of the “violence” in this exercise so that it is tolerable and safe for you to examine. For most people that means revising the attack downward in intensity.

Once you have chosen your preferred attack, have your partner attack you and notice what happens in response to the attack. What do you feel? What do you do? What do you want to do?

There are a number of common reactions to the attack with the tissue. People being hit often experience surprise or fear. They may feel invaded and invalidated. Frequently they tense themselves to resist the strike and the feelings it produces. Some people giggle uncontrollably or treat the attack as a game. Many people get angry and wish to hit back. People may freeze in panic, and some people go into a state of shock or dissociation.

Most people talk about feelings and mental states. They are surprised, angry, afraid and so on. They want to escape or fight back. However, a very different way of paying attention to yourself is possible. Notice the details of your muscle tone, breathing, body alignment, and the rhythms and qualities of movement. Where in your body do you feel significant changes? What are you feeling in those locations? Rather than speaking in mental terms— about feelings, thoughts and emotions—it can be very productive to speak in body- based language.

By paying attention to the physical details of your responses, you will begin to see more deeply into the ways you handle conflict. And learning to notice what you do is the first step in changing and improving what you do. Notice what you do in your throat, belly and pelvis. What happens in your chest and back? Notice what you do in your face and head. Notice what you do with your arms/hands and legs/feet. What happens to your breathing? Is there anything else to pay attention to?

Most people realize that they tighten up when they are attacked. They may clench their shoulders or harden their chests. They most likely tense or stop their breathing. They may lean back or lean forward, but it is a tense movement. Sometimes this tension is fear, and people shrink away from the attack. Sometimes this tension is anger, and people lean forward and wish to hit back. Do you do any of these things? Do you also do something else? Many people find that they get limp as a response to being hit. Their breathing
and muscles sag; or they look away and space out, simply waiting for the hitting to be over. They may feel their awareness shrink down to a point or slide away into the distance. Many people find that they experience both rigidity and limpness simultaneously in different areas of the body.

Some people find the role of the attacker far more difficult than the role of the victim, but we will focus on the responses of the person being attacked. However, one idea might make the attacker role easier for you. It will help to remember that your attack is a gift to your partner. By being concerned and benevolent enough to attack your partner, you are allowing them the opportunity to develop self-awareness skills. Without your gracious cooperation, they would not be able to learn these skills, and when they faced real challenges in their lives they would be completely unprepared.

The common denominator in responses of tensing or getting limp is the process of getting smaller. Fear and anger narrow us physically, mentally, emotionally, and spiritually. However, softening and opening the body is the antidote to contraction or collapse.

FURTHER PRACTICE
How can you go further in learning and using Embodied Peacemaking? Daily practice of the for exercises described here will take you a long way.

You could also work through the exercises in one or another of my books or videos, which are available on my website. You could form a study group to have partners to practice with. Unfortunately life brings many conflicts and many traumas, so
there will be no shortage of opportunities for practice.

 

PAUL LINDEN, Ph.D. is a somatic educator, a martial artist, and an author. He is the developer of Being In Movement® mindbody education. He has a B.A. in Philosophy and a Ph.D. in Physical Education, and is an authorized instructor of the Feldenkrais Method® of somatic education. He has been practicing and teaching Aikido since 1969 and holds a sixth degree black belt in Aikido as well as a first degree black belt in Karate. His work involves the application of body and movement awareness education to such topics as stress management, conflict resolution, computer ergonomics, music or sports performance, and trauma recovery.

Some of Paul Linden’s books and videos

Embodied Peacemaking —Five Easy Exercises. 8 page handout. Free download.

Reach Out: Body Awareness Training for Peacemaking—Five Easy Lessons. 46 pages.
Free download.

Embodied Peacemaking: Body Awareness, Self-Regulation and Conflict Resolution. 164
pages.

Teaching Children Embodied Peacemaking: Body Awareness, Self-Regulation & Conflict
Resolution. 70 pages

Feeling Aikido: Body Awareness Training as a Foundation for Aikido Practice. 300 pages.
Winning is Healing: Body Awareness and Empowerment for Abuse Survivors. 410 pages.

Embodying Power and Love: Body Awareness & Self-Regulation. 10 hour video
Talking with the Body: Body Awareness Methods for Professionals. 9 hour video

Downloadable from www.being-in-movement.com

Dehumanizing is so Human

Paul Linden, PhD

www.being-in-movement.com

paullinden@aol.com

How can people bear to cause other people pain? How can people embrace racism, sexism, political and religious violence, and hatred? A major part of the answer is that it is all too easy for people to see the world through fear and anger and to view other people as not fully human. But in dehumanizing others, people dehumanize themselves. And in so doing, they become numb and can hurt others without feeling it.

However, this is not simply a political, cultural, psychological or spiritual problem. This whole process takes place in the body. Though most people do not notice it, emotions are actions that we do in the body. Hatred is something that is done in the body.

To change how we feel, it is not enough just to decide to stop destructive feelings. The body must be taught to not hate. And in a sense that is impossible. It is impossible to stop a negative. It must be replaced with a positive. Through specific and concrete body techniques, it is possible to teach people to create, understand and use in their lives a body state of awareness, power and compassion. This is not the whole solution, but it is a necessary foundation. It moves people to feel others as human and to care what happens to them.

Based on his 50 years of practice, Paul has developed a short series of simple, powerful transformational exercises. By using concrete and testable language in teaching, Paul can help people learn very rapidly how to apply these techniques effectively in their lives.

PAUL LINDEN, PhD is a body awareness educator, a martial artist, and an author. He is the developer of Being In Movement® mindbody education, and founder of the Columbus Center for Movement Studies in Columbus, Ohio. He holds a BA in Philosophy and a PhD in Physical Education. He has been practicing and teaching Aikido since 1969 and holds a sixth degree black belt in Aikido as well as a first degree black belt in Karate. In addition, he is an instructor of the Feldenkrais Method® of somatic education. He has extensive experience teaching people such as musicians, athletes, business people, computer users, pregnant women, adult survivors of child abuse, and children with attention deficit disorder. Paul has written numerous papers on diverse topics. He has also authored a number of e-books and videos, among which are (at www.being-in-movement.com):

• Embodied Peacemaking: Body Awareness, Self-Regulation and Conflict Resolution

• Winning is Healing: Body Awareness and Empowerment for Abuse Survivors

• Embodying Power and Love: Body Awareness & Self-Regulation (10 hour video)

• Talking with the Body: Training for Helping Professionals. (10 hour video)

Grief

There is a lot to be in denial about. A lot to be angry about. Depression. Bargaining with our healthcare system, government, creditors, families and futures. These are the phases of grief, and we are all in process together. Denial. Anger. Depression. Bargaining. And lastly, somehow, we will begin finding acceptance.

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(Click here for a soundtrack to your reading)

Most often grieving is something we do alone, in relative seclusion. We feel others cannot understand our loss and the depth of our anxiety, anger or depression. Grief is usually lonely. Even with the best support of others.

But what we have been given here is the mandate to grieve collectively in quarantine. Six feet away from hugs. Socially distanced. Closed off from the jobs, activities and places we would otherwise have busied ourselves within. Even though we are isolated, confined to our homes, we all know deeply that we are not in this alone. Globally, we know others are in the same place. Denial. Anger. Depression. Bargaining. Acceptance.

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Within the walls of our homes we are faced with ourselves. Whether you are home alone, self-sufficient or dependent on others. Happily in relationship. Horribly in relationship. Little kids. Teenagers. Adult family. Addictions. Mental illness. Physical illness. Chronic pain. Chronic stress. Binging on NetFlix or on yoga classes. Cooking. Cleaning. Creating. Trying. Grieving. Doing the best we can. Collectively this is the world stage.

Denial. Anger. Depression. Bargaining. Acceptance.

These stages were first outlined by Elisabeth Kubler Ross in 1969 to explain what people go through during loss, specifically around terminal illness. But grief is all around us. We suffer loss all the time. It would be healthy if we all let ourselves fully experience it. But we deny. We get angry. We become depressed. Anxious. We medicate. We blame. We barter. We almost get there, but fall back into the loop before we accept, integrate and move on.

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Even though they are synonyms, I don’t think ‘acceptance’ means that we have to agree with what has happened. There doesn’t have to be approval or consent. Just acquiescence, submission, compliance. For whatever reason this all happened, we all wish it hadn’t. We wish we still had a source of income. We wish we were not entertaining and ’homeschooling’ our kids all day. We wish we could go do the things that made us feel ‘normal.’

We can deny it all and try to escape in a variety of forms. We can get mad and pissy with one another. We can cry. Be apathetic. Be empathetic. We can do all of these things in a given hour. And we are. All over the world.

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This is not the lonely grief that separates us. This is the combined, communal, mutual grief that bonds us. Nobody can play the martyr and stall progression. The vigor that drives survival slacks when it all becomes chronic. An over-worked, burned-out survival instinct has landed humanity at a fork in the road where people will have to choose how they settle into coping.

Amidst the bargaining, we must try to negotiate the pieces back together. We have to reach out to others. We have to share our stories. Many who have never accepted help from others will have to. Many who have never worn the heart of a ‘helper’ will have to become one. New options will have to be explored. A new plan. All of this must happen, in whatever order it does, before we can move on. Denial. Anger. Depression. Bargaining. Acceptance.

Be it a global pandemic, it is an individual choice. All of those individual choices will add up to something brand new. Acceptance. Equanimity. Hope. Certainty that it will all be ok, even if we can’t possibly begin to know exactly how.

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What is ‘Integrative Medicine?’

Integrative Medicine? Functional Medicine? Complementary? Alternative? The buzzwords have changed a lot over the past many decades and public interest has forced academic and western medical attention to the field.

 

For me, it has been lovely timing that I was starting my graduate academic life in the late 1990’s – right around the time that the that the National Institutes of Health (NIH) created the original framework to address the growing conversation and implement a funding paradigm for research into this growing field.

 

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NIH started with 4 primary domains of complementary and alternative medicine (CAM) placed around a central health system of allopathy, or western medicine. (Energy. Mind-Body. Mechanics. Biology)

I most passionately believe that a strong support network is the foundation of well-rounded, grounded, good healthy living. It keeps you in check and gives you something to fall back into. We all long for inspiring confidants, creative professionals, and trusted support beside us on our journey. The current culture of our health care system though often leaves us taking what we can get instead of healing within the creative, comprehensive support we all deserve.

Over twenty years of private practice and 3 integrative health centers later – I now work with an expanded model. This 6-Domain model draws attention to the importance of knowledge and awareness. I have never seen anyone overcome a terminal illness or shed a chronic condition if they did not both deeply understand the disease process at hand and deeply know what they believed about where life comes from, why life is worth living and where we go when we die.

In my professional definition and use of the language – Integrative Medicine, most simply, is a conscious effort toward distributing wellness efforts/resource in a balanced way across these six domains: Knowledge, Beliefs, Biology, Mechanics, Mind-Body and Energy.

It is often true that we tend to ‘cluster’ our care into a few select domains while nearly or completely neglecting others. Working within this 6-domain model allows for the balancing of resources (time, finances, energy, etc.) while still providing comprehensive support and an honest framework for addressing concerns and goals in a balanced, sustainable way.

Knowledge

How much do you know about your health?

Do you get regular physicals, eye exams and dental exams? Do you understand any diagnoses you may have? Do you understand the medications and supplements you take – why are you taking them? and generally what are they doing in your body? Do you have easy access to your medical records and images and understand what’s in them?

This domain is about taking the central position in your health care and assuming responsibility for your wellbeing. If you cannot directly assume responsibility, then it means finding a patient advocate and creating a flawless support network around you.

Actions related to this domain can include getting regular health screenings, asking questions of health care providers, reading, learning, seeking support and using effective methods for organizing your health records.

Beliefs

What do you believe in?

What are your beliefs around where life comes from? What are your core beliefs and how do these translate into your health, spirituality, finances, emotions and relationships? What we believe and our connection to our beliefs has a tremendous impact on our health and treatment outcomes.

First you have to know what you believe in. Then you can find tools you resonate with to sit in an ever-growing space with their beliefs, faith and paradigms. Spirituality is one aspect of beliefs.

There are various health systems around the world – Allopathy (Western Medicine), Osteopathy, Homeopathy, Naturopathy, Ayurveda, Chiropractic, Osteopathy, Traditional Chinese Medicine, etc. They all have very different core beliefs about the origins of health and disease.

Western medicine is the primary medical system we operate within and our insurance payment systems are organized around it. Western medicine is a health philosophy based upon a symptom-response method for assessment, treatment (and payment).

Biology

What are you doing that directly impacts your biological functioning?

This domain includes our diet choices, supplementation, pharmaceuticals, environmental factors, sleep and exercise.

Mechanics

Is your human form mechanically sound, adaptable and of structural integrity?

This domain includes therapies that work directly with structural body mechanics to influence change. Posture, neuromuscular activation, musculoskeletal balance, fascial integrity and structure-function efficiency are the primary focus of these therapies. This domain is working tangibly with bones, muscles, fasciae and neuromuscular relationships.

Mind / Body

How can you bridge the space between your mental and physical experiences?

These somatic techniques train the body to inspire the mind and teach the mind to positively shape the body. The term ‘somatic’ means ‘experiencing the body from within.’ Our thoughts, feelings, beliefs, and attitudes can positively or negatively affect our biological functioning. Our bodies can become tools for working with our mental state and our mental patterns can become vehicles of change for our physical bodies.

Energy

Are you aware of and attending to the energy fields in and around your body (biofields)?

These modalities encompasses the use of external energy sources – electromagnetic fields, vibration, sound, frequency, thermography, etc. – to influence health and healing. Therapies in this domain work with energetic fields using aspects of vibration, electromagnetism, light, heat, auras, chakras, meridians, intuition and discernment.

Applying the Integrative Model to Your Life

So … how can you apply this to yourself? Which domains do you tend to most naturally? Are you over-attending to some domains and avoiding others? Do you need help putting your team together?

These are all conversations and resources I am happy to have with anyone! Regardless of what community you live in, the framework still applies. If you are in central Ohio, then we can help even more specifically by plugging reputable providers into the gaps in your network.

Health is a community endeavor. It was meant to take a village. There is a village to support you no matter where you are or what you are going through.

Lymphatics & Circulation – The Applied Anatomy

The functional anatomy and structural integrity of the lymphatic system is, unfortunately, a greatly under appreciated dynamic in the quality of our everyday lives. Frequently the importance of the lymphatic system is nested in conversation of the circulatory system as a whole or in immunity at a cellular level. There are key principles that guide a conversation of the lymphatic system.

  1. Maintenance: The lymphatics absorb excess fluid, proteins, electrolytes, toxins and foreign debris from the tissues. This cleanses the tissues and thereby maintains functional integrity of the connective tissues.
  2. Transport: The lymphatics transport substances between the tissue compartment and the blood. Through this function the lymphatics help to localize infections in the body.
  3. Defense: Immunocompetent cells are generated and distributed by the lymphatic system.

FUNCTIONAL INTEGRATION OF THE SYSTEMS

It is important to note that many authors combine the lymphatic system into the cardiovascular system; the systems are so intricately interwoven that it is certainly fair practice to treat the systems as a single larger system. When thinking of the circulatory system it is absolutely appropriate to view it as a huge circle that starts and ends at the heart.

The lymphatic system is profoundly unique in its unidirectional nature. All other systems in the body are circular from a functional standpoint. This is not the case with lymphatics. This microscopic, blind-ended vasculature begins in the tissue space (interstitial space) and then converges upon itself forming larger and larger vessels. These vessels will specialize into nodes throughout the body.

Lymph nodes can be found in most of the areas of the body where there are ‘pockets’ to provide safety and room for nodes to rest. These areas are referred to as nodal beds. Nodes, for instance, are found under the medial and lateral malleoli under the ankles (malleolar nodes), behind the knees (popliteal nodes), in the hip crease (inguinal nodes), in the connective tissues of the abdomen (mesenteric nodes), under the armpits (axillary nodes), deep to the muscles of the neck and under our jaw bone (cervical chain nodes). There are between 400 and 1000 nodes in the body; over half of the nodes are located in the abdomen. Lymphatics are pervasive throughout the entire body, with one exception. The central nervous system has no lymphatics.

As fluid passes from lymphatic capillaries to vessels to nodes and onto larger vessels into lymphatic trunks, the fluid moves closer to the heart and will eventually converge on the subclavian veins. At the junction of the subclavian vein and the internal jugular vein the lymphatic fluid is returned to the systemic circulation.

EMBRYOLOGY

The lymphatic system begins functioning around the 5th week of fetal life. Its developmental path closely mimics that of the circulatory system. It is most widely believed that lymphatics develop as outpocketings of the veins in the developing fetus. As such they follow the route of the veins traveling from the periphery toward the heart. The 2 central ‘sacs’ form during the 5th week and allow for the drainage of the head, neck and upper limb. During the 6th week, 4 additional reservoirs form to drain the lower limb and abdomen. When the mature lymphatic system has formed, there is one thoracic duct that drains the entire body, except for the right side of the head and neck, right upper limb right thoracic region. The right lymphatic duct is also part of the final anatomy of the lymphatic system and it serves to drain only this right upper quadrant region of the body.

THE FLOW

Blood is ejected from the left ventricle of the heart and travels via a system of arteries and arterioles to vast networks of microscopic capillaries. There are only 2 tissues in the body that do not have blood supply (cartilage and epithelia). The dense mesh of capillaries nutritionally supports all other tissues. Capillaries are the place of exchange. Cellular wastes are exchanged for nutrients in the arterial blood. Carbon dioxide is exchanged for oxygen.

The capillary is literally just one cell thick. Many substances can pass through the cell membrane, while others require transport proteins to carry them across specialized membrane ‘tunnels’ to the other side. The membrane is selectively permeable, meaning that the size and shape of its ‘tunnels’ will only allow certain molecules across.

Importantly the large red blood cells are retained inside the capillary. They are simply too big to cross over into the tissue space. Only a clear filtrate of the blood is permitted to pass into the tissue space. When this fluid was part of whole blood it would have been termed blood plasma. Now that this fluid has filtered out of the capillary and into the tissue space, it will be called tissue fluid, or interstitial fluid. In the space between all of the tissues in the body there is this fluid. It acts as part of the interface for the transfer of nutrients and wastes between cells.

Interstitial fluid can be considered the ‘clear phase’ of the circulatory system. ‘Clear’ refers to the relative color of the fluid itself. When erythrocytes, or red blood cells, are added to the fluid it takes on a dark red appearance that we usually think of as blood. When the red blood cells are sieved out of the fluid, a clear(ish) colored fluid is left behind. This fluid bathes the cells and acts as a medium for the exchange. This fluid will come to contain a relative sampling of the state of the tissue space. For example, if there were bacteria present the tissue fluid would contain indicators of a potential infection.

Each circulatory cycle, the tissue fluid is filtered out of the capillary, acts as a medium for exchange in the tissue space and then the tissue fluid re-enters the capillaries, becomes part of the blood plasma again and returns to the heart. Fluid returning in the veins will travel through a system of venules and veins before entering a vena cavae and returning to the heart and closing the loop of the circulatory system. In the systemic circulation:

heart > arteries > capillaries > veins > heart

But … not all of the tissue fluid returns to the circulation in this manner, some fluid will take a different route through the structures of the lymphatic system. About 10% to 20% of the tissue fluid is taken up from the tissue space not by the venous side of the capillary, but by a blind-ended lymphatic capillary. Once the tissue fluid enters the lymphatic capillary it is appropriately termed lymphatic fluid, or lymph. This ‘sampling’ of tissue fluid could be thought of similar to quality control in a factory setting. If a factory makes shoes they do not carefully inspect each shoe that comes off the line, rather they take a sample (maybe 10 to 20%) of the shoes and inspect them as representative of all the shoes. Our lymphatic system exists for this function, to act as ‘surveillance’ for the body. The proportion of tissue fluid that enters the lymphatics will take a different journey, through immunological checkpoints, called lymph nodes, before reentering the blood plasma of the veins.

capillaries > vessels > nodes > trunks > right lymphatic duct/thoracic duct > veins

Most of the body will drain ultimately its lymphatics through the thoracic duct. The upper right quadrant of the body has its own unique drainage pattern. We will see later that the right side of the thorax, right head/neck and right upper limb all have unique circulation compared with the left. Bilaterally, lymph is dumped from the main trunks into the subclavian veins that run under the clavicle [sub, under; clavian, clavicle). These veins join the superior vena cava and thereby return to the fluid as a component of whole blood to the heart.

THE LYMPH NODE

Lymph travels through the lymphatic vessels to nodes where a sort of ‘percolation’ takes place. Think of a coffeepot. It has a hole in the top to dump a good deal of fluid into. For our conversation here this is analogous to the lymph coming in the afferent ducts of the lymph node from the periphery. The coffeepot has a chamber wherein the fluid is slowed down and altered. This represents the node. Inside the node the fluid will be surveyed for potential situations that will require an immune response. Fluid leaves through a very small opening and continues in the same direction onto its next fate. The fluid may pass through multiple nodes before reentering the blood plasma at the subclavian veins. Lymph nodes function specifically to:

  • Filter and purify the lymph
  • Capture and destroy toxins
  • Concentrate lymph
  • Produce lymphocytes (which increases as flow through the node increases)

FUNCTIONAL INTEGRATION OF THE SYSTEMS

So, the circulatory cycle begins with a nutrient and oxygen rich phase that brings these elements to the tissues (the ‘red’ phase). At the smallest level of the single celled vessel, the capillary allows for exchange (the ‘clear phase’). Most of the waste and carbon dioxide is carried back to the heart through the venous system (the ‘blue’ phase). A small amount of tissue fluid (‘clear phase’) is carried into the lymphatic system where it acts as a biological sample for surveillance of the status and needs of the body before returning to the veins just before they enter the heart.

Victimhood

Angry victims. Empowered Victims. Defeated Victims. Passive Victims. We have too many victims in the world today. When my husband was in cardiac rehab last year, he sent me this text. A man on the treadmill next to him dropped some wisdom …

“There is a growing phenomenon of people posing as victims which is a consequence of a culture which portrays victimhood as a form of moral superiority.”

How is it that some people go through the trenches and back and just simply never become a victim of it all? No matter what life throws, they aren’t victimized by it. They find courage, persevere and blaze ahead. And then there are others, apparently enduring victims of a past or daily victims of the present. Chronic victimhood worn as a badge, worn like a quiet secret, worn like an excuse and heart-string for the world. Some create false bravado to overcompensate their pain, others act like sages sanctified in their empowered victim status. How did we become a culture of so many victims?

Has the world really given us more to be victimized by? Or, have we just become more inclined to identify, embody and claim the title and role of ‘victim.’ Like the guy on the treadmill said, ‘a form of moral superiority.’ Anyone who experiences injury, loss or misfortune has been a momentary victim of events, circumstance or another person. But then there are those that choose to carry their victimhood as a steady undercurrent, a backdrop, a medal of something earned. It turns into an invisible ‘award’ allowing them to be treated and regarded differently, apparently forever, because of what they’ve endured.

But, trauma and loss are not enough to make somebody a victim. Anne Frank, Jackie Onassis, The Dalai Lama, John McCain (insert the names that come to you here …) Tremendous loss, grief, suffering and pain and not an ounce of victimhood.

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A victim and a hero are very different things.

Psychologically, the underpinnings of victimhood are the feelings that:

  1. There was harm,
  2. I didn’t cause it,
  3. I couldn’t have prevented it,
  4. It was unjust, and
  5. I deserve empathy …

The desire for empathy – maybe that’s the element we have more of in our culture these days. Perhaps people are just craving empathy, sympathy, compassion and understanding.

The perpetual victim avoids responsibility and criticism, while receiving attention and kindness. While they might play the empowered victim, the humbled victim, the angry victim, the grieving victim, the healed victim… But, they are still so very wounded. Wounded teachers. Wounded prophets. Wounded healers. Their sense of worth all wrapped up in what happened to them with the hope that the world love them differently because of what they’ve been through. In the short term, it draws some people near. In the long term, the fallout can be seen trickling through their relationships and interactions like an acid. Unfortunate. Reactive. Eroding.

You want to love them, support them, see the strength and survivor in them. So, you overlook behaviors that are really pretty self-serving, narcissistic and manipulative. These people can come off as the heroine in the corner, having overcome so much with wisdom and heart now to face the world more bravely because of the sadness and misfortune they met in the past. The undercurrent there though is victimhood layered in coping. It’s sad. It’s misguided.

If victimhood becomes a permanent mentality, it becomes a tool of abusive power, grooming others, gaining special treatment and regard, soliciting sympathy and evoking compassion. It buys cooperation and opportunity and becomes something of a talent, drawing people and bringing out their altruistic motives. It also draws more victims into their company.

It becomes a pattern to blame for undesired situations and feelings. It becomes a pattern to deny personal responsibility for their own life, circumstances and emotions, even if it looks like they are taking it all by the reins. In this blueprint, there will always be more suffering, more casualties, more wounds, more loss.

A forever-victim, even if wrapped in the trappings of a Guru, is duped, tricked, scared of being a target and ultimately playing the fool. And, they end up duping others, making them a target and making them look the fool. For somebody who has overcome so much, it seems so sad to sabotage themselves and those around them again and again and again.

Victimhood, regardless of form, is an imbalance. It requests permanent special status. It asks others to support you differently. It becomes a distorted way to draw people toward you and attempt to claim power. And really, it fuels the whole victim story.

The opposite then would be balance, self-confidence, equanimity. A victor. A leader. A champion for themself and for others.

In the end it becomes a, perhaps totally denied, belief that their suffering is their only access to power. Their heart is not full of love because it is that way, it is full of love because they have been a victim of so much loss. Their spirit is not strong because it is that way, but because they have been a victim and had to fight. They don’t have to admit that they are angry, because they can instead act hurt. They don’t have to face life, because they are a victim of what life has given them.

Victimhood, denied or realized, inhibits us from recognizing and consciously wielding power we already possess.

Having suffered loss, a crime or betrayal at the hands of another, is a temporary condition. Everyone will experience wrongdoing, disloyalty, devastation or defeat at some point. But, it does not take on a special status for everyone. There is no moral, spiritual or metaphorical superiority to having lost in life. Life is loss. Life is suffering. Life is change. Coddling the angry victim just feeds their need for the anger. Putting the empowered victim on a pedestal just fortifies the mistaken coupling of their worth with their pain.

There needs to be a growing phenomenon of people posing as victors. No apologies. No cover stories. Value in vulnerability and in strength, not because it follows misfortune but simply because it exists in all of us.

Enthusiasm (‘En-‘ + ‘Theos’)

Breaking down the word … ’enthusiasm’ comes from the prefix en- (‘within you’) and Theos (‘God’). So, to be enthusiastic is to have the spark of God within you. To speak with enthusiasm means you are speaking divine words that light up from within you (and likely light you up). We can’t necessarily pick (or shake) the things that ignite light and action.

Enthusiasm for a cause is a divine gift. Let’s start there. But the question, “why does it matter?” is a very fair one. One worth revisiting as the years roll on for sure. I’ve been asked this a lot over the past year and I’ve had to really listen to my answers. I’ve sat with myself and played with a related question, “could I just let it go and drop it?” Could I just go to work, take care of folks one person at a time, and drop this vision for cooperative, integrative community-centered heath care? I have been a volunteer for the cause since the late 1990s. Maybe I have had and done enough?

Apparently, no. I can’t drop it.

I suppose it is the ‘fortunate’ that have this sense of purpose about something in their lives. So, to be able to ponder the notion of living on that purpose and how much of our life we want to give to that purpose is a consideration of privilege and a rich blessing. To feel so compelled, so passionate, so unwaveringly pulled to create and co-create is a very hallowed double-edged sword. These internal missions drive our use of time, our priorities, our finances, our relationships and our direction. It is necessary to sit with ‘it’ from time to time and be sure that we are still willing, enthusiastic stewards of the cause.

If it is your ‘Life’s Work’ then it will not be shake-able until it has fulfilled its potential. So here we are. Here I am.

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Almost every single person I see in my private practice has been struggling for far too long. If they are lucky enough to have found a good team of practitioners, it is solely up to them to keep that team in communication and their information sorted out. Amidst their suffering, they are forced to be their own ringleader. More often and sadly, people arrive with huge gaps in their support network. These people can’t get well with such holes in the foundation of their healthcare.

I see all ends of it. There are basic needs, like a primary care doctor and standard preventative strategies. There are more creative needs, like integrative teams of experts putting their heads together. We should be able to do better to serve the public and help people in need. I know many of us have ideas about what that could look, feel and operate like. And apparently, I have an undying enthusiasm for bringing it all to fruition.

Resources are finite. It is a truth no matter who you are or what you are dealing with. Energy. Time. Money. Emotional wherewithal. We ultimately only have so much reserve to cope, adapt and heal with. And, when somebody has been living with a chronic condition, those stores are already tapped. It is unrealistic and relatively unkind to expect that a general person would or should be able to navigate the healthcare landscape, much less when they are already low on resources across the board.

It shouldn’t be that hard to provide a simplified framework, create efficient paths for approach and bring together teams of providers. It just requires an infrastructure, community effort and community support. The notion of community has to be front and center in the healthcare/wellness care conversation. I can’t believe we can create healthy people in the absence of healthy (or at least authentically striving to be), engaged community.

One part of the framework is the ‘6-Domains of Integrative Medicine’ educational tool along with the personal support to implement it into a sustainable and thoughtful wellness strategy. Another part requires thoughtful virtual engagement of a broad, diverse and reputable community of wellness providers. And the final, perhaps most important part, is a relationship with the public that offers various, comfortable, engaging points of entry and contact.

This way, when a person is in need they know where to find resources immediately. They don’t waste months and years floundering trying to put together their own piecemeal team and educate themselves through Dr. Google. They don’t waste a ton of money, time and energy on disparate services, questionable providers and incomplete treatment plans. They know right away, ‘I have this great infrastructure in my community that brings me reputable integrative health and wellness resources I can trust and access easily.’

We all know and have felt the big, confusing abyss between inpatient care and outpatient wellness. We all know there is an infrastructure needed to fill this void. These can’t just be words that sound good and feel good to speak. There needs to be action. There needs to be engagement. There needs to be vulnerability and transparency. There needs to be evolution and impact.

Obviously, I’ve been sparked. Community-driven integrative healthcare delivery really matters to me. It matters a lot. It is clearly my ‘Life’s Work’ and I won’t be able to drop it until its potential, or my role in it, has been fulfilled. Enthusiasm. It is quite a thing …

(And of course – please consider supporting IntegrateColumbus by donating financially, volunteering, putting your voice in the conversation or just staying in the loop!)