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Can primary care physicians jump start the complex PTSD healing journey of the underserved?

As efforts to shine light on the underlying causes of health risk continue, especially as the disparities have become even clearer during this pandemic, the focus remains on the connection between adverse childhood experiences (ACEs) and the burden created on the human body individually and the healthcare system as a whole.  I am so grateful for Dr. Nadine Burke Harris, California’s Surgeon General who established early childhood, health equity and ACEs and toxic stress as key priorities, with a goal to reduce ACEs and toxic stress by half in one generation.

It still amazes me that so many people are not aware of the ACEs data that show the trauma our children endure, especially within low-income communities of color.  It has been out for years and continues to be collected every year, with expanding definitions of what constitutes adverse childhood experiences.  And it becomes frustrating when our healthcare systems continue to simply look at the symptoms of trauma, such as addiction, depression, and anxiety, without addressing the root cause.

I’m encouraged, and I hope you too find it encouraging, to learn that Dr. Burke Harris is starting with a campaign to provide Medi-Cal providers training, clinical protocols, and payment for screening children and adults for ACEs.  For more information on this campaign, you can click here.

It is also encouraging to hear about the research looking at other approaches to the chronic effects of trauma that are showing positive outcomes, especially within underserved primary care patient populations.  One particular pilot study tested the feasibility of a two-session motivational treatment intervention, implemented with Black primary care patients.  The intervention addressed adverse childhood experiences, post-traumatic stress symptoms, health risk behaviors and behavioral health referral acceptance.  The results were encouraging, suggesting that it is feasible to implement a brief motivational treatment with underserved primary care patients, that was received well and connected almost one-third of the participants to behavioral health services to continue the healing journey.

To read more on this pilot study, click the link below:

Online Reiki-infused gentle movement and meditation class!

This online class will be conducted using WebEx’s video conferencing, which gives you the choice to turn off your camera to support giving yourself permission to make this practice your own and to facilitate a reduction in distractions.  For first-time attendees, we will need to secure a signed release of liability form, which will be sent to you via email.  Once we have this form, along with payment via PayPal, we will email you the link and meeting ID to join us on Sunday, 26th at 4 pm PST.  We look forward to be of service to you!

5 Intention-setting Ideas to Reduce Inflammation During Times of Transition

The experience of the season of Spring seems to reflect Ralph Waldo Emerson’s quote above – and, no wonder, Spring might be the most eagerly awaited change of seasons of the year for many of us!

At the same time, did you know that it is also the time of year when suicides peak?

Researchers are beginning to uncover why this world-wide trend might exist.  Adam Kaplin, MD, a neuropsychiatrist at Johns Hopkins, suggests that there is overwhelming evidence that links inflammation to depression and suicide.  One of the sources of inflammation is seasonal allergic reactions, with chances of depression being 42% higher for people with rhinitis.  So, although Spring may, at first glance, seem full of rebirth and like a welcomed time of transition, it too comes with the reminder that all transitions come with challenges.

So, although you might not be currently experiencing depression (or suicidal thoughts), becoming aware of the impact that inflammation has on the body and mind can help to support you through this seasonal change, as well as other times of significant change, such as navigating the stress of moving or from the loss of a job.

Please consider the following intention-setting ideas to support your immune system, especially when navigating transitional times which tend to increase the experience of inflammation in the mind and body:

  1. Nasal cleansing.  Consider investing in a Neti pot and trying a daily practice of washing out the irritants from your nasal passages.  Using a sterile water and salt mixture has been shown to reduce sinus inflammation and the symptoms of an itchy nose, sneezing, sinus headaches and the long dreaded sinus infections.  This practice can also be used to prevent and treat symptoms of colds and the accompanying inflammation, since it takes 8-12 hours for a cold virus to replicate within your nose.  If you are hesitant to try out this practice (and who wouldn’t be a little scared to fill your nose with water as we are humans for goodness sake and not fish!), check out some of the videos on YouTube to get tips on how to overcome the fear.  My suggestion would be to start a practice now before the pollen levels grow even more!
  2. Legs-Up-The-Wall.  Known as Viparita Karani in Sanskrit, this restorative yoga shape supports and strengthens your immune system, among many other benefits.  It can be done anywhere, including the back of any door in your home or office.  The longer you hold it, the greater the reduction in stress (AKA inflammation), in both the mind and body.  Perhaps holding this shape for 10 minutes each day for a week and sense into the difference it might make in your energy levels, clarity of thoughts, and quality of sleep.
  3. Alter what you eat. There is much written about the impacts of the types of fuel you add to your body, so it is not my intention to promote any specific “diet” out there.  I’m offering the suggestion to consider adding one or perhaps two new “premium” sources of energy to your existing routine.  For example, adding foods that are rich in antioxidants, known as polyphenols, has been shown to reduce inflammation.  These foods include onions and red grapes, the spice turmeric, and green tea.  Consider simply adding one of these each day for one month.  Another example is adding more omega-3 fatty acids, which includes olive oil, ghee, flaxseed oil, and fatty fish such as salmon, sardines, and mackerel into your meals.  Now you can’t convince me to eat sardines, but I have switched over to ghee, so perhaps you might too!
  4. Immerse yourself in a Sound Bath.  What is a sound bath you might ask?  Well, it is an experience where you listen to sounds that are soothing to the nervous system.  Music has been shown to ‘speak’ to the body’s autonomic nervous system, the part of our nervous system that controls the unconscious functions of our bodies, such as our heart beat, and reduce the level of cortisol (i.e., the stress hormone).  It has also been shown to improve the body’s immune system functioning, have a positive effect on the brain, and enhance cognition.  Perhaps take a moment now and do a search in your area for the next Sound Bath event at a local yoga studio, health spa, or holistic practitioner’s office space and schedule it in your calendar.  If you are sensitive to sounds, consider trying a one-instrument sound bath, such as Crystal Singing Bowls or Gongs first.
  5. Practice meditation.  Both meditation and self-compassion practices have been shown to reduce stress-induced inflammation.  Consider finding an online self-compassion meditation that resonates with you and implement a daily practice, perhaps each night before going to bed.  If you would like to read a little bit more about how meditation reduces inflammation, check out this article from HuffPost.

As always, if you try any of these intention-setting ideas for holistic health, I would love to hear about the impact they might have had for you.  Please send me an email at linda@sanctuary4compassion.com to share!

Spreading the word, expanding awareness, lifting consciousness – healing trauma with yoga!

Growing up in a family that was “broken” by divorce for multiple generations, I experienced a great deal of stress as a young child navigating the after-effects of such an interpersonal event without any logical awareness that such an event would someday be viewed as trauma.  Many people may view post-traumatic stress disorder (PTSD) as a condition that predominately affects our military service members.  And while it is true that research focusing on veterans returning from war contributed significantly to the creation of a formal diagnosis of PTSD, the experience of combat is not the only source of trauma leading to this diagnosis.

To support efforts to bring more awareness to the experience of trauma during PTSD Awareness Month, I want to first highlight what type of events and/or experiences may underlie the diagnosis of (complex) PTSD and second, recent research that suggests yoga is a promising complementary treatment that not only helps to reduce the symptoms of PTSD but also supports personal growth, including increasing feelings of compassion, gratitude, acceptance, and empowerment.

According to the National Center for PTSD, types of traumatic events that can lead to PTSD include:

  • Combat and other military experiences
  • Sexual or physical assault
  • Learning about the violent or accidental death or injury of a loved one
  • Child sexual or physical abuse
  • Serious accidents, like a car wreck
  • Natural disasters, like fire, tornado, hurricane, flood or earthquake
  • Terrorist attacks

And as I talked about last month, the Adverse Childhood Experience Study (ACES) measured additional types of childhood trauma, leading to a diagnosis of complex PTSD, including the following:

  • Personal trauma
    • Physical abuse
    • Verbal abuse
    • Sexual abuse
    • Physical neglect
    • Emotional neglect
  • Trauma related to other family members
    • A parent who is an alcoholic
    • A mother who is a victim of domestic violence
    • A family member in jail
    • A family member diagnosed with a mental health disorder
    • The disappearance of a parent through divorce, death or abandonment

As the understanding of how the human body-mind interprets situations that don’t appear immediately life-threatening from the casual observer but none-the-less traumatizing to the person grows, it is vital that alternative treatments beyond medication and therapy be considered when considering the percentage of the overall population impacted by such experiences.  When considering complex PTSD which stems from a child’s inability to utilize the body’s natural “flight or fight” distress response to escape from a destructive family dynamic, such as the psychological ware zone of a contentious divorce, the body is forced into a freeze response for survival.

In this freeze state, the body is still full of adrenaline and cortisol, yet the child shuts down, dissociating from the body’s natural response sensing its inability to help.  At this point of development, the logical brain’s cognitive abilities to understand and act are still forming, so the body and mind are at odds, where the body continually senses danger yet the mind feels helpless to relieve the threat.  Symptoms that reflect a diagnosis of complex PTSD include:

  • Loss of emotional and physical awareness
  • Dissociative episodes
  • Self-harming behaviors
  • Difficulty regulating emotions, such as anger
  • Somatic complaints, such as headaches and stomach aches
  • Overdeveloped sense of responsibility
  • Chronic sense of guilt
  • Difficulty trusting people or feeling intimate
  • Helplessness
  • Hopelessness

As a “thriver” post PTSD and a trauma-informed yoga practitioner, teacher, and psychotherapist, I understand the need to engage both the body and mind along the healing journey toward re-integration and balance after trauma.  So it is not only important to familiarize ourselves with the nature and impact of trauma but it is vital to know what treatments are available and found to be effective so we can guide our loved ones with compassion towards healing and provide hope.

My own journey of healing first led me to the traditional psychotherapy experience, which did help to move me from victim to survivor through awareness and understanding.  However, I still found myself chronically anxious and easily triggered into an unbalanced state of mind.  Then I found myself in a yoga class.  I was immediately hooked by the change I experienced in my body that day, although not completely aware of what the change was exactly.  After integrating a regular physical yoga pose and breath practice on the mat into my life, I increasingly became aware of a palpable sense of relaxation in my body and a sense of peace in my heart.  My breath pattern became a reflection of my state of mind and a guide toward maintaining balance in my body-mind connection.  I learned that I could control my breath and when I focused on my breath I was able to change my reaction to a trigger to a response to a stimulus.  I found that the breath creates space to keep the body-mind aligned when navigating the world.  As I continued my practice and explored additional mindfulness techniques over time, my capacity for gratitude and compassion grew, I felt more connected to myself and others, I was more accepting and less judgmental, and my ability to remain centered even in chaos has steadily increased.

With my own personal healing journey as evidence that body-mind strategies are necessary to turn off the sympathetic nervous system and release chronic tension in the body, and reflect to discover the beauty in our challenges, I am excited to share some recent research that supports my experience with yoga as an important treatment option for complex PTSD.  In this study, 31 adult women with PTSD related to chronic childhood trauma participated in a 10-week Trauma Sensitive Yoga (TSY) class.  For the results, click on the link below: