Tools In The Kit, A Primer For Self-Care Part III

(For your convenience, a PDF of the complete article is available for download)

Tools In The Kit

After Part I and Part II of this series, we’re now ready to delve into the self-care kit itself.  Please keep in mind that the modalities, practices and considerations detailed below are in no way a substitute for professional medical advice. They constitute what I have explored and found to be useful along my path – your mileage may, and likely will, vary. I also refrained from neatly slotting them into any one compartment of the biopsychosocial model as they are all intertwined, touching upon and potentially supporting one another in various ways.

 Activity – Movement/Resistance Training/Cardio-Respiratory Fitness

“The only bad posture is the one you stay in for too long.”

– We are cocooned in an increasingly automated world, designed for convenience, minimizing challenge. By and large, human beings are moving far less than we have at any point in history, neglecting our evolution as an active and highly mobile species. The result has been increases in type 2 diabetes, cardio-respiratory disease, bone density loss and other controllable and preventable illnesses. Even putting those aside, the number of aches and pains requiring medications and outside interventions could be greatly reduced if we simply moved more, and more often.

The entirety of your being benefits from regular movement, from your muscles, to your connective tissues, to your heart and other organs. It even helps to keep your brain healthy, particularly if it’s complex, coordinated movement like dancing.

It’s easy to be dissuaded by the thought of hour after tedious hour spent on a treadmill or stationary cycle, but there are countless other fun and novel ways to get yourself moving. While I started with, and still teach yoga, personally, much of my time these days is spent learning via non-hierarchical platforms like the Axis Syllabus, which studies movement through an evolving scientific lens – meaning, when understanding about the human body and how it moves changes, so does the instruction. Such knowledge has greatly informed the way I reside in my body, as well as how I teach others to find the same in themselves.

– Done smartly, resistance training helps to maintain bone and muscle mass, particularly during the often rapid decline of the two in later life.  Now, actually picking up a barbell, practicing  push-ups, or hopping on a circuit machine can seem a daunting task, especially if you’re in a gym surrounded by people who have been doing the same for years. In these instances, it can help to remember that everyone there was in your place for the first time at some point and that all roads to mastery begin with that initial, tentative step.

My own resistance training regimen largely consists of whole body, heavy lifting – exercises like squats, deadlifts and the clean and press, that make use of the same large muscle groups that I utilize in everyday (and not-so-everyday) activity. And since yoga is chock-full of pushing movements and largely bereft of pulling actions, in the gym I also focus a good deal on the latter – pull ups/downs, seated and kneeling rowing, and brachiation, simply hanging around.

– For those trying it for the first time, the activity that provokes the most apprehension tends to be cardio-respiratory exercise. If you’ve never felt your heart rate surge or gasped for air from the sustained exertion of running, climbing, rowing or swimming, your body and brain can create formidable resistance in trying to maintain its sedentary status quo.

Thankfully, your heart responds to exercise just like any other muscle in your body, becoming stronger the more you actively use it and resting better when you don’t. When I first returned to running, after a twenty plus year absence, I’d typically find myself gassed out after a short stint – a kilometer to a kilometer and a half. While initially disheartening, within months, that number crept up to three, then five. Eventually, I was able to complete ten kilometers of mixed surface (pavement and trail) running with relative ease. Of course, once I learned the benefits of nasal-only breathing during exercise, it felt like I was starting anew (mucus, so much mucus…) But that too has become easier over time, and is now a technique that I routinely recommend to others who have picked up the running habit.

Counselling/Therapy

Full stop, there is still far too much stigma surrounding mental health. If we afforded the same degree of attention to the deeper workings of our minds as we do our bodies, we’d likely be living a considerably more harmonious existence – with ourselves, each other and the planet on which we reside.

 If you’re already struggling, feeling vulnerable, then reaching for help – too often misperceived as a sign of weakness – can feel overwhelming. But some of the smartest, strongest people I know are those who have the capacity to admit when the puzzle pieces of their current mental and emotional landscape just don’t seem to fit.

It took me both prolonged time and introspection to become aware of an inherent unhappiness I’d carried from childhood well into my adult years, and to be able to see the litany of limiting emotional habits and roadblocks I was unable to work through by myself. Growing up in an abusive household with an alcoholic step-parent, I was headed down the same dire road until I decided to find someone to talk to about my own addiction and long-term depression.  I would not be where I am today had I not taken the step of making an honest assessment of my mental and emotional well-being, having subsequently spent years working through my “stuff” with various mental health professionals. Whereas the thought of seeking professional counsel once felt intimidating, it is now reassuring to know that such a lifeline is out there when I require it.

The other common barrier to mental health care is cost – quality therapy is often prohibitively expensive.

One option is to find a general practitioner physician who has moved into a counselling practice. In my home province of Ontario, these services are typically covered by our tax-funded health insurance. The downside is that the doctor you have your sessions with may not have as an extensive background in mental health as someone who has focused solely on that field of study. If, in counselling, you start to feel like you’re talking in circles and are not resolving much – something I’ve previously encountered – then your doctor might not be particularly skilled as a therapist and it may be time to move on.

While in the minority, organisations such as Toronto not-for-profit Hard Feelings offer experienced, professional, short-term counselling on a reasonable, sliding-scale, in an effort to make therapy  available to as broad a range of people as possible. I availed myself of their services when I experienced some challenges last year, and my caring, considerate counsellor and I did wonders together in helping me to get back on track.

Diet

On all levels, our bodies require fuel to function optimally. Yet there are so many variables when it comes to diet, that finding the proper one for you can turn into a venture in frustration. Fad diets, ones that sell the notion of rapid weight loss, are dangerous and often lead to a rebound effect that can result in more weight being put back on than was initially lost.  Then there’s keto, paleo, vegetarian, vegan, raw, macrobiotic…with their proponents all claiming the one they follow to be the most effective and beneficial, who’s right? Oh, and if you aren’t already confused, calorie counting is outmoded and doesn’t work, and supplementary vitamins and so-called superfoods rarely meet up to their typically inflated claims.

So, how the heck do you figure out what to eat, how much to eat and when to eat it?

One thing most medical sources agree upon is that the glut of low-nutrition, high calorie, highly processed foods currently available on supermarket shelves is contributing to a wealth of childhood and adult disease and illness. Food-wise, our brain and its capacity for invention has jumped well ahead of our physical evolution, which hasn’t changed all that much since our hunter-gatherer and early-agriculture based ancestors populated the planet.

If the field of evolutionary biology has any say in the matter, it turns out that a return to basics, with consideration to one’s forbearers, may be one solid piece of the dietary puzzle. As science journalist Michael Pollan succinctly puts it, “Eat Food. Not too much. Mostly plants.*”

Another area of dietary study that’s gaining medical traction is gut heath, a.k.a. our microbiome – the trillions of microorganisms that inhabit our bodies and that, it turns out, wield a strong influence on everything from our weight to our mood. While research is still in its infancy, we can look to the longstanding use of fermented foods in various cultures as a possible means to maintain a healthy balance of intestinal flora.

If there’s one useful takeaway from the wealth of research out there, it’s that there’s no ONE diet that’s best for everyone. Finding your optimal balance of nutrition and quantity is an evolving process, and one which we’d do well to not become overly pedantic about, lest we strip the joy out of preparing, sharing and savouring good food – aspects which I’ll argue are also vital parts of healthy eating.

(*with the type of plants somewhat dependent on your family origins)

Meditation

I was somewhat reluctant to include meditation in the self-care kit, primarily due to the fact that there’s no one specific way to meditate and that various methods of doing so produce various results, with not all of them being beneficial. While people have been meditating for millennia, the practice has only undergone more rigorous scientific scrutiny over the past few decades, with the results being inconclusive at best, and at worst, unhealthily biased.

That caveat firmly in place, finding time to be in stillness and in conscious awareness can serve as a means to counteract the busyness and mostly external focus of day-to-day living. Meditation can help us become aware of our mental conditioning and, if we don’t like what we see, to take necessary steps to modify it (see Counselling/Therapy). MRI and EEG scans of monks with lifelong meditation practices show markedly different brain activity from the average individual, suggesting increased neuroplasticity (essentially the brain’s capacity for change/adaptation), focus and memory, and feelings of connectedness with others and the world around them. It requires noting that the study sizes were small (in these two articles, 20 and 27 participants) and did not take into account the monks’ regimented daily routine, relatively sequestered existence and their support systems, aspects that might also factor into how their brains form and function.

While my preference these days is toward moving meditation (which still fits the practice’s mandate of single-minded focus), my initial foray into yoga involved many hours (three thousand or so, at last estimation) spent seated on a cushion, eyes closed, narrowing my attention to my breath as it entered and left my body, then to observing the accompanying bodily sensations. Endeavouring to remain present within and to learn to be non-reactive to whatever arose during those times, I experienced states of intense euphoria and equal discomfort. There were sessions when my breathing shortened to a near-imperceptible puff,  my mind following suit to become as still as the glassy surface of a pond on a windless day – literally, not a thought in my head, which was a godsend for my (at the time) overthinking self. In other instances, my mental activity was akin to a tempest, with all manner of unpleasant and untoward contemplation roaring to surface. At other times still, I would be stuck in seemingly endless thought loops – on one retreat, I had a Led Zeppelin song lodged in my head on auto-repeat for three straight days. I was instructed to simply be o.k. with all of this, which as you might imagine, is much easier said than done.

Did my meditation practice help me on my path to wellness? Perhaps. I like to think that it did, but I was also instigating myriad other changes in my life at that time, that also likely contributed to increased feelings of well-being.

If you’re prone to anxiety, the thought of weathering the various states I described above might already be ramping up your nervous response. If this is the case, then traditional seated meditation may not be right for you. And that’s o.k. Meditation is far from the panacea it’s often claimed to be, and many of the schools and teachers that offer instruction are ill-equipped to handle adverse reactions that might arise from practice.

If you do decide to try meditation, it’s best to do so under the tutelage of an experienced teacher, preferably one with trauma-informed training. If you do begin to experience adverse effects – increase in negative symptoms such as anxiety or depression, prolonged bouts of sleeplessness, hypersensitivity to light or sound, dissociation (a feeling of disconnect from yourself and others, diminished enjoyment of usual activities), or “rebounding” into an increase in harmful, addictive behaviours  – it would be wise to cease practice and to consult with either a physician or mental health practitioner.

Massage/Manual Therapies/Bodywork

Being a shiatsu therapist, I can admit to a bit of a bias on this one. It also needs to be noted that the science surrounding the benefits of massage is rather lacking, with the majority of claims that are often made by those working in the field being unsubstantiated. These include everything from massage helping the body to eliminate “toxins” (our kidneys and liver do most of that work for us), to fixing joint “misalignment” and bulging discs, to curing asthma and arthritis. Massage therapists are often guilty of using medical language to detail the purported effects of treatment, when most in the profession do not possess any formal medical training. If your therapist attempts to diagnose you or claims that they can cure a specific condition with bodywork, it’s likely time to seek out someone with more appropriate ethics and a better understanding of their scope of practice.

All that said, in an increasingly touch-deprived society there’s still a lot of benefit to be had in a quality massage session, under the hands of a caring and compassionate practitioner. The relaxation that results from a good massage has been shown to reduce blood pressure. If you come to a treatment in pain, the novel sensation of pressure or kneading can provide a temporary distraction from your symptoms, which can help to signal your nervous system to reduce its clutch on your body. Probably the best unspoken benefit of bodywork is that it can be both calming and motivating to feel cared for. When you get a taste or reminder of what it’s like to feel better, this can serve as fuel to facilitate other constructive life choices.

So, just because many of the touted benefits of massage are disputable, it doesn’t mean that massage itself isn’t useful – quite the opposite. I would not be practicing shiatsu had I not experienced what was sometimes profound release and relaxation via the numerous treatments I’ve received. And as a therapist, it always makes me happy to see the look of relief on the faces of clients who initially come to me in pain and discomfort.

As with counselling, the high cost of bodywork can sometimes create a barrier to feeling better. Since I first began practicing shiatsu ten years ago, I have offered rates on a sliding scale  –  if you’re experiencing financial challenges, it can never hurt to ask a potential therapist if they provide the same.

Play and Creativity

As adults living in a society obsessed with productivity, it can be easy to fall into the belief that play is solely the realm of the young. But the adage that all work and no play makes for dull children carries well past those formative years.

While research on adult play is still nascent, with a reduction in perceived stress being the most reported benefit, it doesn’t take a scientist to understand the advantage of entertaining activities that take us out of our usual routines. With so much of daily life revolving around schedules and organization, allowing time for the spontaneous, purposeless and amusing can help to maintain a suppleness of both body and mind.

The best part is that the definition of play is open-ended and can be as simple or complex as suits your personality. Some enjoy mandala colouring books, some longboarding. Others prefer constructing Rube Goldberg machines, while others still, like a little bit of everything. My favourite way to play is DJing electronic dance music. It’s a craft I’ve been exploring for over thirty years, one that gets me toying around with eye-hand coordination, my sense of timing and my capacity for improvisation. It’s also oodles of fun, particularly when there are people dancing on the other side of the booth.

If you’re saddled with the feeling that you’re in a rut, it can be helpful to take stock of the amount of time you allocate for play in your life. Often, a little can go a long way.

Rest

If your idea of rest is a nightly five or six hours of somewhat turbulent sleep, coupled with a week or two of “I can’t really, but I need to” vacation every year, it’s likely time to reevaluate your downtime.

Rest is our body and mind’s way of integrating information from its waking hours, as well as recuperating from its daily stresses. Lacking in proper rest, stress levels tend to increase, which in turn ramps up the secretion of hormones like cortisol – necessary for the completion of both day-to-day and long-term goals, but damaging on multiple levels when produced in excess. The harmful effects of cortisol overproduction include weight gain, psychological issues such as anxiety and depression, problems with learning and memory and diminished capacity to heal.

Knowing that you can’t just revamp your sleeping patterns and with most work environments unsuited to daytime napping, what’s the solution? Reconceptualising your notion of rest is a good place to start. Rest can include simply making time to step away from whatever it is that you’re normally doing and changing up your scenery, particularly if you have access to nature. This gives the mind a break from the incessant treadmill of task organisation and completion, with a correlating reduction in stress.

If you’re constantly feeling spent, another option is to occasionally supplement your usual exercise time with “non-activity” such as restorative yoga. This is the yoga of conscious rest, using support from props such as bolsters and blankets in reclining postures held for sustained intervals and that are designed to remove effort from the equation. These prolonged stints of unwinding activate your body’s parasympathetic nervous response – lowering your heart rate, decreasing cortisol production and promoting repair. In my own experience, I’ve found restorative practices to be useful as a “reset” when I’m overloaded, feeling like I can’t put anything more on my proverbial plate. Residing in northern climes, it can also be of immense benefit during the winter months, following nature’s lead of the season’s relative quiet and stillness.

Understanding Pain

If you’ve ever been injured, you might have an appreciation of how confounding the subject of pain can be. Why do we sometimes continue to experience pain, long after physical damage has healed? Why do we sometimes feel pain in areas distant from the injury? Does structural damage necessarily predict pain?

The growing theorisation is that while pain is not merely “all in your mind”, on any given occasion, a good part of it likely is. External factors like the influence of others (family, friends, co-workers, surrounding culture) and beliefs surrounding pain can also wield marked effects on how severely it’s experienced, as well as the capacity to recuperate from it.

For those at the forefront of pain science study, the biopsychosocial model is paramount. This consideration toward the myriad factors that influence our experience of pain is increasingly accompanied by what can be termed “movement optimism” – the removal of fear or avoidance-based prognoses in injury recovery programs, instead encouraging adaptive exploration aimed squarely at a return to previously enjoyed levels of activity.

The best part is that some researchers have gone to great trouble to boil down years of findings into accessible, simple to understand literature for us lay folk. I began to examine my understanding of, and relationship with pain via Greg Lehman, a Toronto-based physiotherapist and chiropractor who tours his Reconciling Biomechanics With Pain Science workshop worldwide, and who offers a free Pain Science Workbook, available for download in eight different languages. It’s an excellent read for both therapists and patients alike.

Dedication and perseverance

Reading this lengthy list, you might be thinking, “Yeah, right. And where am I supposed to fit all of these activities into my already packed schedule?”

When I first began looking into ways to better my self-care, I didn’t know how I was going to manage it all, either. And there were many times when I’d “slip and skip” – falling into physical or emotional ruts that took me off schedule and sometimes made me feel like I was taking several steps back for every one I took forward. The key was to persevere – not necessarily doing it all, but on any given week, doing what I could. Maybe a short run on one day, then a few days off before hitting up the gym. If my energy was flagging the following week, then perhaps a restorative yoga class. At a pub get together for a yoga group I work with, one student was shocked when my order of a burger and fries arrived at our table. My point is that perhaps it doesn’t always have to be about militaristic regimens (“boot camp” workouts, anyone?), salad greens, chickpeas and quinoa, but instead about balance and an evolving exploration of challenging yet enjoyable day-to-day routines. It’s great to be able to complete a 20k bike ride, and sometimes it’s equally self-nourishing to spend an afternoon binge-watching your favourite series on Netflix.

Something I like to relay to nearly every person I work with is that in fostering fierce and compassionate dedication to your own self-care, you become less reliant on external healthcare systems that are already strained at the seams. And remembering the adage, “as within, so without”, you’re also better able to extend that same care to others. In my years of practice, my one consistent finding has been that when you commit to actively participating in your own health and well-being, everybody wins.