My ruckus making is…

Inspiring our mental health providers to provide their sharpest game and supporting people in healing their trauma to live their best lives. I provide training programs for counseling graduate students and, a few months each year, I act as the lead therapist and interim director for a holistic rehab in Hawaii.  

My focus is…

Creation, Connection, and Contribution, especially around methods for healing. More than anything, I want to support others in accessing internal peace. I want to contribute workshops, community spaces, a wiki group therapy platform – that can continue to grow without becoming stagnant on the creator, articles, systems, apps, and especially new ideas. This shapes most of my life decisions. Saying no to a lot, so I can have the time for creation, connection, and contribution.

I also love learning lots of stuff, especially different approaches to healing, thinking and living. That’s why I absorb so much from a multitude of fields, explore the world, and want to keep absorbing and growing. I connect with those who stretch, strive, and grow, and love having meaningful conversations with others about their view of how things work. I’m optimizing my life for learning and connecting.

013 Changing Behavior Exercise

Here’s a quick exercise to apply when you are someone your working with is stating a desire to change a behavior, yet they haven’t done it yet. I first learned it working at this Holistic Rehab. I’ve added to it theories that might explain why it works, to support in a deeper understanding of why it may be more difficult to change our behaviors when we don’t take the time to consciously address underlying beliefs.

If you would like to see a video of this exercise, go to: https://www.youtube.com/watch?v=-5Pj0Tew1rk

012 Integrative Mental Health and Depression Interventions

In this episode, I touch on what integrative mental health means to me, go over criteria so support you in selecting interventions that are meaningful to you, and list some integrative interventions for depression. I would love to hear your thoughts. Please feel free to post on my website or email me. Here are the show notes:

Depression as a heat and inflammatory response. 

  • Scientists are discovering there are different subtypes of Alzheimer’s 
  • Beliefs are that we will see this is the same for many different mental health concerns
  • So many interventions are effective, yet not one intervention is effective for everyone

Possible Depression Interventions:

  • 2 grams of EPA Fish Oil per day
  • Broccoli Sprouts of 2 cups per day or lesser amount of sprouts with a Broccoli Sprouts Powder Pill – It’s still important to eat the sprouts as the same time of the pill. Miocene is destroyed when broccoli sprouts are powdered, without Miocene the body can’t produce Sulforaphane from the broccoli sprout powder. Some people have a gut bacterium that produces an adequate amount of Miocene and some people’s gut bacteria produce very little, so take pills with sprouts at the same time or eat 2 cups of sprouts per day.
  • Heat Exposure (Sauna or Hot Bath), Hot Yoga, or intense exercise – 4 times a week for 30-100 minutes, with hot water at 104 degrees, for 4 to 8 weeks. Heat exposure releases about 77% of the beneficial hormones as intense exercise does, so if one isn’t able to significantly raise their body temperature through intense exercise begin with Heat Exposure. Hot yoga volunteers wearing a rectal probe raised their internal temperatures to a similar temperature as participants in an infrared box for 100 minutes. A percentage of people with depression have a low-grade internal fever, though feel cold to the touch. Heat exposure is believed to reset the bodies’ temperature mechanism, as people with heat exposure maintain a lower internal body temperature. Heat exposure also activates opioid receptors in the body and offers pain relief. 
  • Safe Space Exercise, 8-10 times a day for 20-30 seconds (5 minutes a day) – studies showed that practicing an exercise similar to this one, https://nurves.wordpress.com/2009/08/10/a-safe-place-a-relaxation-technique/, for 8-10 times a day, for 20-30 seconds, for 6 weeks, changed blood flow in what was believed to be a beneficial way, increased blood flow in pre-frontal cortex, during scans.
  • Eat a high fat, moderate protein, low carb, and no highly processed food diet for maximum reduction in inflammation. Fats help insulate neuro connections, reducing static and noise in brain, decrease anxious thoughts, and support in deeper sleep. Any highly processed foods should be avoided, eg anything that’s been turned into a powder, even protein powders are quickly absorbed by the body and are more likely to be turned into carbohydrates and have an inflammatory affect. 
  • Fasting as a way to decrease inflammation – recommended minimum to reduce inflammation is 24-hour fasts, so could finish dinner Sunday at 6pm, then on Monday break the fast at 6pm. For people with low body weigh, it’s important to get in a sufficient amount of calories. When breaking the fast eat lots of healthy fats and some healthy proteins. Carbohydrates have an inflammation effect, all processed carbohydrates and sugars should be avoided. Sheep milk/cheese and coconut oil are preferred by the brain. Okay to do “Fast Mimicking” Diet, which allows for fats to be eaten, eg butter/heavy cream/MCT Oil in coffee, macadamia nuts, bone broth, etc. 
  • Somatic Therapies & Meditation  – EMDR, Somatic Experiencing, Trauma Resolution – modalities that work with the body. It is believed that both verbal and physical trauma, as well as other traumas, mentholated the dna, this methylation/change to the epigenetic, can be passed on for generations, increasing cortisol, which is correlated to anxiety and depression
  • Psilocybin assisted psychotherapy – psilocybin is being shown to support amygdala regeneration, this is the part of the brain that takes signals and determines if they are threats are not. Psilocybin assisted psychotherapy is being shown to drastically reduce the default mode network and believed to increase neuroplasticity through this mechanism

Resources to follow:

Notes from Episodes:

Evolutionary Theory – 10,000 years ago we were most likely to die from infections from wounds. When we were emotionally stressed it was more likely that we would be wounded, eg feeling stressed during a hunt or an attack from another tribe. Our bodies would increase their temperature, as this would support us in killing off infections; similar to the theory of why body temperature rises after eating, as a way to kill off any infectious materials in the food.

  • Rhonda Patrick – The Underlying Mechanics of Depression – 9 min video – https://www.foundmyfitness.com/episodes/inflammation-depression
  • Causes of depression – overactivity of our immune system or inflammation, which can be caused by poor nutrition, obesity, poor gut health, sedentary lifestyle, poor sleep and social stress, important to address
  • 2 grams of EPA Fish Oil Per Day, has been shown in studies to reduce depressive symptoms
  • https://www.foundmyfitness.com/episodes/charles-raison
  • Minute 26 depression, minute 38 recap. 
  • Dose 40 minute – powder and sprout over doubles the effect, only sprouts are uncooked croucerfous veggies have miocene, miocene is needed to transform into sulforaphane, and mustard seed 
  • https://www.foundmyfitness.com/episodes/charles-raison
  • 24 hour fasting for depression. 
  • Some people made need more inflammatory stress instead of less, yet majority of people need decrease in inflamation
  • Heat exposure, hot yoga, rectal temperature is the same in hot yoga as in heat exposure box, hot sauna, or even hot bath
  • Heat stress activates u-opiod receptor and has 33% more potency than morphine, and diaphorne is upregulated
  • Taking antioxidants after heat stress prevents beneficial response for depression

011 My Emotional Breakdown or Breakthrough

This week I’m sharing a personal breakdown that happened after an absolutely amazing week of volunteering with Zendo at Lightning in a Bottle. I’m sharing with you my insights of what I learned from it and ways I hope to operate differently in the future, so I’m better able to take emotional care of myself in the future. Maybe you can learn from my experiences and avoid the intensity of my learning experience.

010 Spiritual Burnout and The Phoenix

This is an interesting conversation between Mary and myself. I would love for us to have a follow up conversation on this topic. Here are the show notes:

  • Possible Individual Symptoms
    • Losing Connection, Passion
    • Feelings of Synasism
    • Old practices, such as church or praying that seem to no longer fulfill connection to greater sense of self
  • Burnout in our Society – connection to the universal experience that’s happening in the world right now
    • Structures of Power, Privilege, Government, Finances
    • Feelings of burnout representing greater macrocosm
  • Feeling of burnout not a personal flaw that needs to be fixed
    • empathy for greater system & self
    • Tended to own suffering differently
  • What’s the effect of professionals treating people in fight or flight/sympathetic arousal, on the mirror neurons of the professional?
    • Example of being in the dentist chair with heightened heart rate
  • Disillusionment
    • Beliefs about life and how it all works were being dismantled
    • Beliefs about fair and being in a developed country and working hard will equal success
    • Recognizing how systems are unfair
    • Many people in the U.S. are seeing behind the curtain – unfairness, oppression, racism, structure of power and privilege to maintain success of some and oppression of others
    • Me too movement
      • Helping organizations grow better leaders – saw how organizations protected male leaders, lost faith
      • Larger awareness working ass off to alleviate suffering and support people in feeling, saw that amount of suffering in the world is still the same – heart broken
    • Media and it’s effect
  • Psychedelices & Spirituality –
    • Personal stories
    • Sense of connection and boundaried connection

The relationship between spirituality and burnout among medical students

Medical student burnout has been associated with depression, loss of empathy, and suicidal ideation. Spirituality has been identified in previous studies as a protective factor in coping with the stress but has not been examined as a factor in medical student burnout. An internet link to an anonymous survey was sent via email to medical students at a public northeastern medical school; 259/469 (55.2%) completed it. The survey included measures of spirituality, burnout, psychological distress, coping, and general happiness. A Pearson-r correlation showed significant inverse correlations between measures of spirituality and measures of psychological distress/burnout (r’s ranging from -.62 to -.14; p’s <.01). In contrast, a positive correlation was found between life satisfaction and spirituality (r’s .53 to .12; p<.05). Using hierarchical multiple regression with demographics (Step 1), mental health variables (Step 2), and satisfaction and Adaptive coping (Step 3), burnout remained significantly related to lower scores on both spirituality measures (FACIT-SP p<.00 and DSE p<.05). Students having higher levels of spiritual well being and daily spiritual experiences described themselves as more satisfied with their life in general, while students with low scores on spiritual well being and daily spiritual experiences had higher levels of psychological distress and burnout. Spirituality may therefore be a protective factor against burnout in medical students and future studies should explore potential causal relationships.

009 Mental burnout and Recovery Practices

This episode will cover Mental Burnout and Recovery Practices

Symptoms

  • Rumination
  • Inability to Focus
  • Cynicism or Negative Attitude
  • Connection between Mental Burnout and Self-Sabotage

When you’re burnt out your lack of mental energy may lead to:

  • Procrastination
    • I’ll do it when I feel better when I’m less exhausted
    • I’ll do it tomorrow
    • I’ll get to it later
  • Poor Systems and Routines
    • No energy for creating efficient ways of doing things
    • Inefficient actions mean you spend more energy doing tasks
    • Task may get done but you are more exhausted after doing them
  • Poor Planning and Chaos
    • Flying by the seat of your pants
    • Doing it when you “feel” like it rather than planning for it
    • Doing what comes “naturally” to you rather than what’s best for you
  • Vicious Cycle
    • Every day is a bad day
    • You wake up with the right intention but lose energy and momentum, fall behind, get disorganized and discouraged
  • Negative Self Talk – occurring both at times of growth and when regressing into old patterns – difference in the voice

Hope – There is hope for things to change

Studies – prevention is best, early multi-model intervention next best

Course of mental symptoms in patients with stress-related exhaustion: does sex or age make a difference?

  • The course of mental illness in patients seeking specialist care for stress-related exhaustion was not related to sex or age. The burden of mental symptoms is high and similar for men and women, and at the 18 month follow-up, one-third of the study group still showed symptoms of burnout. A long duration of symptoms before consultation was associated with a prolonged time of recovery, which underlines the importance of early detection of stress-related symptoms.
    • All patients were offered multimodal treatment (MMT) with similar components but adapted to their individual needs during the whole follow-up period of 18 months
      • Usually visiting the physician with an interval of four to six weeks
      • Physical activity and other lifestyle topics were repeatedly encouraged
      • Eight-week stress reduction group programme
      • Two-hour lecture, teaching basics about stress and the consequences of chronic stress exposure
      • Employers, working colleagues and relatives were also offered to attend a short lecture regarding stress-related mental disorders
      • Cognitive behavioural group therapy for insomnia and/or a recommendation to visit a psychologist for individual psychotherapy were other treatment methods.
      • Offered to participate in an aerobic exercise group and strength training at the clinic once a week for 18 weeks and 20% (n = 47) participated; the rest were recommended individual physical training.
      • Antidepressant medication was offered or adjusted when needed.
      • Communication with the Social Insurance Office and the employer was facilitated, and about half of the patients participated in special meetings regarding the earliest possible return to work.
  • The burden of mental symptoms is high and similar for female and male patients, and at the 18 month follow-up, one-third of the study group still show symptoms of burnout despite extensive MMT

Symptoms that may be stress-related and lead to exhaustion disorder: a retrospective medical chart review in Swedish primary care

  • Patients with exhaustion disorder appear to consult their general practitioner numerous times with stress-related complaints in the years preceding their diagnosis. The findings indicate which presenting complaints general practitioners may need to be more attentive to so that patients at risk of developing exhaustion disorder can be identified earlier and get the support they need. Addressing stress factors earlier in the course of illness and preventing the development of exhaustion disorder may contribute to a reduced burden for both individual patients and for society, with a reduction in sick leave and societal costs for mental illness.
  • The presenting complaint at the occasion when the exhaustion disorder is diagnosed, are:
    • Nausea, irritable bowl, headache, dizziness, palpitations, chest pain, back pain, musculoskeletal pain, abdominal pain, and feeling faint

Self-reported stressors among patients with Exhaustion Disorder: an exploratory study of patient records

  • Work demands are, by far, the most prevalent stressor, followed by relational problems in private life… One important practical implication of this study is that patients with stress-related exhaustion often have a long period of impaired ability at work. Successful prevention at the workplace is thus of great importance. However, it is equally important to discuss how society can support individuals such as single parents or couples with relational conflicts.

Mental Practices to Prevent or Soothe Burnout

  • Notice your Thinking Patterns
    • What are you unconsciously or repetitively saying to yourself about your situation?
    • What are your beliefs about your situation?
    • How are your thinking patterns and beliefs affecting how you feel?
  • Negative Self Talk Exercises
    • Have a conversation with this Negative Self-Talk
    • Thank the voice for caring about you
    • Listen to it fully as you can
    • Listen for the deeper, underlying values and needs that it’s asking for
    • Take an immediate and then a longer term action to meet it’s request
    • Request a gentler interruption next time, that’s easier for you to hear
  • Planning & Systems
    • Possibly with someone you trust – when in burnt out less able to plan
    • Evaluate your goals
    • Creating an actionable plan, with small achievable steps
  • Ask for Help and Support
  • Take Care of yourself now
  • Do the restorative activities sooner
  • Sleep – Oura Ring

008 Physical Burnout & Restorative Activities

This podcast looks at the Burnout and how it affects us physically. Below are the show notes:

  • Moral Injury and Burnout
    • Societies desire to not go deep and address top layer issues instead of root cause, sometimes could include Solution-focused (brief) therapy (SFBT)
  • No Energy yet difficulty with Sleep
    • Sleep deprivation is being shown to increases amygdala activation.
      • A study showed that while both groups expressed significant amygdala activation in response to increasingly negative picture stimuli, those in the sleep-deprivation condition exhibited a remarkable +60% greater magnitude of amygdala activation, relative to the control group
      • A sleep deprived person may see an event as an emergencies (due to activated amygdala) that needs to be urgently addressed, when in fact those that have had more sleep interrupt what’s needed differently
    • Loneliness and Withdraw due to sleep deprivation
      • A study demonstrate that a lack of sleep leads to a neural and behavioral phenotype of social withdrawal and loneliness; one that can be perceived by other members of society, and reciprocally, makes those societal members lonelier in return. We propose a model in which sleep loss instigates a propagating, self-reinforcing cycle of social separation and withdrawal.
    • Cognitive abilities, behavior, and judgment
      • Multiple studies have been done to determine the effects of total sleep deprivation; more recently some have been conducted to show the effects of sleep restriction, which is a much more common occurrence, have the same effects as total sleep deprivation. Each phase of the sleep cycle restores and rejuvenates the brain for optimal function. When sleep is deprived, the active process of the glymphatic system does not have time to perform that function, so toxins can build up, and the effects will become apparent in cognitive abilities, behavior, and judgment.
  • Feeling tired & wired
    • A combination of physical exhaustion or low physical energy while simultaneously feeling anxious or wired, stressed
    • Being unable to feel rested even if you are getting enough sleep
    • Body confused about not getting enough light and enough darkness; circadian rhythm
    • Body and stomach pains. Gut hurting when stressed and eating
    • Chronic exhaustion
    • Some people experience aches and pain
      • When people feel emotional pain, the same areas of the brain get activated as when people feel physical pain: the anterior insula and the anterior cingulate cortex. A study on social rejection seemed to demonstrate this.
      • The body isn’t getting enough natural light or enough natural darkness
      • We live in man-made boxes of artificial light
  • To go deeper into the sleep studies, please see Rhonda Patrick, PhD & Matthew Walker PdD
  • Practices – Physical
    • Breathing – Breath of Fire
    • Eating well-balanced meals
    • Sleep – 7-9 hours, before 10:00 pm; sleep hygiene and artificial lights
    • Exercise, gentle
    • Sex
    • Touch, Massage, Self-Massage, Cuddle – serotonin and oxytocin
    • Play, Dancing, Coloring, Drawing – engaging a younger or more carefree part of yourself
    • Get outdoors and touch the ground
  • What is it you need? And how are you going to implement this?

007 Therapeutic Use of Psychedelics

  • This podcast discusses common questions about Psychedelic Assisted Psychotherapy and Therapeutic Use of Psychedelics.
  • Some questions answered includes:
    • How many treatments?
    • What does it look like?
    • What’s being worked on?
    • How does it support connection to one’s body?
    • What are the advantages or disadvantages?
    • Who is this not for?
    • What kind of training and preparation should a therapist have in order to do this?
    • What advice do you have for someone considering this therapy?
    • What are the preconceptions and which ones aren’t true?

Please note – there was a recording issue that made this episode more tin sounding. This error has been fixed for all moving forward. Thank you for your understanding. We wanted to share this content.

006 Emotional Burnout & Support

Mary Kuentz and Laura Wade explore their journeys through emotional burnout, some of the research about burnout symptoms.

  • Definition of Burnout
    • Mechanical – When there’s nothing left to combust, no more energy in the system
    • Emotional “burnout” was coined in the 1970s by the American psychologist Herbert Freudenberger. Emotional burnout describes the consequences of severe stress and high ideals in “helping” professions. Doctors, therapists, coaches, and other healers, who sacrifice themselves for others, would often end up being “burned out” – exhausted, listless, and unable to cope. It’s the shadow side of self-sacrifice. We will be looking at how to support without sacrificing and what to do when you’re already sacrificing.
  • Mary and I are passionate about taking Holistic views, so we will be discussing how issues affect us on an emotional, mental, physical, and spiritual levels.
  • Today we will be looking at the Emotional side of Burnout, and including how to know when you’ve entered the spectrum of burnout and what to do about it.
  • Emotional Signs of Burnout
    • Reduced Performance (difficulties in maintaining boundaries)
    • Emotional Protection/Isolation – Flat Affect Feels, nothing to look forward to, joyful things from the past no longer seem joyful in the present
    • Hopelessness about the state of the world and being unable to affect the issues of the world. Suffering is still happening in the world. What’s the use?
  • Practices to Heal Emotional Burnout: 3 practices, 2 and 1 of micro and large
  • Self-Empathy – begin to practice self empathy that you would give a friend client or loved one
    • Journaling – stream of conscious writing, to give it a place to vent
    • Take a Break, a day, a week – Emotional Well-being Day
      • May be different from a SPA DAY!
  • What’s the one shift, easy and doable, that would make the biggest difference?
  • How can you begin integrating that shift into your life, even in a small way?
  • Stop Blaming yourself for feeling burnt out
    • Many people keep pushing, internally and externally to overcome burnout in the early stages, i.e., “If I can just finish this project…” “If I can just get to Friday…” “If I can just push through this pain…”
      • Pushing to keep up
      • Punishing themselves to be who they have been in the past
  • Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: What is burnout? 2012 Dec 5 [Updated 2017 Jan 12].Available from: https://www.ncbi.nlm.nih.gov/books/NBK279286/
    • Listed 3 main symptoms of Emotional Burnout:
      • Exhaustion: People affected feel drained and emotionally exhausted, unable to cope, tired and down, and do not have enough energy. Physical symptoms include things like pain and stomach or bowel problems.
      • Alienation from (work-related) activities: People who have burnout find their jobs increasingly stressful and frustrating. They may start being cynical about their working conditions and their colleagues. At the same time, they may increasingly distance themselves emotionally, and start feeling numb about their work.
      • Reduced performance: Burnout mainly affects everyday tasks at work, at home or when caring for family members. People with burnout are very negative about their tasks, find it hard to concentrate, are listless and lack creativity.

Feeling discomfort when trying to relax is part of the process

The scientific model tells us that nothing is proved as true, it’s just not wrong yet. Here’s Dr. Feynman brilliantly explaining the scientific method.

I come across many models that don’t seem to hold up when I compare them to different studies or how I see them working with my clients.

One model that seems to keep proving it’s worth is Dr. Saj Ravzi’s Stress Response Hill, shown below. Check out his entire video, it’s worth the investment of time. The one point of his I want to highlight, is that most of us are operating at the “1”, we are slightly activated most of the time, and when we try to do mindfulness or relaxation exercises to get to the “0”, we may actually fell more agitated. It’s common to then think the exercise must not work, when actually the agitation in the body increases before it fully relaxes, so the increase in agitation means it’s working. I find this model extremely helpful to explain to clients prior to beginning relaxation exercises, as it helps them understand the increase in anxiety is part of the process.