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Understanding and treating the complex chronic patient – an interview with Isobel Knight

Singing DragonFebruary 20, 2013 1 Comment

What makes treating the chronic complex patient so difficult? Do you think there is still a lack of understanding about how best to approach this?

I think that practitioners are very scared by complex chronic conditions and can become very overwhelmed. I’ve had so many medical professionals dismiss me because they really didn’t understand what the problem was. Treatment of chronic complex conditions really does require a multi-disciplinary team of people and medical experts, as well as an overarching approach to treatment plans. This can all be overwhelming for one person.

Conditions become chronic and complex over the years. There’s often a long delay in diagnosis (research by the Hypermobility Syndrome Association in the UK suggests that diagnoses can take about 10 years). As an individual gets older, he or she will gather more problems, which makes treatment even more difficult, relating to more bodily systems. If the condition is intercepted younger, these can all be addressed and hopefully better controlled.

How has being an individual with EDSIII (Ehlers-Danlos Syndrome – Type 3, Hypermobility) influenced the way you treat people in your clinic?

Based on what I’ve experienced, I can certainly spot the condition very quickly in people who haven’t had a diagnosis. Although I can’t officially diagnose, if the symptoms are there, I can get them sent to their GP for a referral to an expert rheumatologist. So in this way it’s really helped some people. I also know what ongoing management they are often going to require, so I can both refer them on to practitioners that I know, and support them with Bowen Therapy in the areas that I know they will need help with.

I’m never overwhelmed by what patients say, and I always believe them. And that helps a lot.

Why did you choose the autoethnographic approach in writing your new book?

That was inspired by an author I quote in the book, who wrote about life with a kidney condition and eventually turned it into a PhD thesis. I thought it was a really good way of framing the book. It uses my story as a basis, but also weaves in the stories of others, to ensure that it’s socially representative of that culture group. But also, this is a personal story. I include some quite personal details, and I hope that this makes it much more accessible to read, not a dry textbook. It really says how the patient feels, from my point of view and from the points of view of others.

In the book, you go into quite a lot of depth on the psychology involved both in having a chronic complex condition and in treatment. Do you think that the importance of this area is underestimated?

Yes. I was actually really surprised how large the psychological section of the book ended up being. There are so many layers to it, trust being a very important one. The issue of trust is so important for any medical professional dealing with a chronic complex patient. Personally, I had been consistently told by a range of professionals that the pain I was experiencing was psychosomatic, and that there was nothing wrong with me. I think that most patients have years of that to contend with. In so many cases these conditions involve a legacies of problems that haven’t been fully handled since a young age. Behaviours change because of pain. That really has an impact on people. They get angry, they get depressed, they get anxious.

I’ve also included a section for the patient on managing chronic pain, cognitive behavioural therapy, and other psychological aids such as goal-setting, pacing, ways of communicating and dealing with doctors.

Medical professionals also need support psychologically in dealing with the complex chronic patient because, as mentioned, treatment can be very overwhelming for them, and quite emotionally draining. If one of your patients comes back every week with little improvement to their pain, it can be emotionally difficult as a therapist to make a positive spin on it and focus on treatment.

Social media seems to be a really supportive, positive force for the treatment and understanding of these conditions. How do you see this developing in future?

I think that because some patients with this condition can become quite disabled, and socially isolated, Facebook, for example, can be a real lifeline for them. It’s a way for them to get mutual support, to learn more about the condition, to realise they’re not alone in their experience. I’ve been staggered by the response to my Facebook page, and how it’s being used internationally to provide support and share information on this subject (but never any medical advice).

How do you hope this book will help professionals working with, and patients with the syndrome?

I hope that the patients will be able to see that there has been, in my story, quite a positive improvement due to the level of care I’ve had, and the experts I’ve managed to have access to. Physiotherapy has been essential in this. I’d like to offer patients hope but also the reality that this is a genetically inherited condition, which is about management, not cure. I hope that the book provides not only treatment information, but validation – they can take the book to their doctors to show them what’s going on. It’s as up to the minute as up to the minute can be in terms of medical research and practice.

In terms of the medical professionals, I hope that they can understand the full impact of a multi-systemic chronic complex condition, what it means to have bodily systems not working very well, and the impact that this has psychologically, physically and socially. I hope this helps them to develop a bit of a more empathetic approach.

I’m incredibly lucky to have been able to have 6 real experts in each field contributing to the book. This means that they’ve been really able to bring the book up to date with the latest research on treatment and medical management of the condition. That’s a real privilege.

First steps in promoting hair regrowth, for anyone affected by Alopecia and other hair-loss problems – with Vera Peiffer

Singing DragonFebruary 20, 2013 13 Comments

When your hair is falling out, you are not just having a problem with your hair, but also something else in your body, no matter whether you have other symptoms or not. As I’m explaining in my book Regrowing Hair Naturally, there is a reason why your hair is falling out. This reason is some form of toxicity.

Water and hair loss

Toxicity in your body makes your body too acidic. While some acidity is very important for body processes to function correctly, over-acidity is a problem and can lead to hair loss. If you then also don’t drink any water during the day, the acidity stays in the body undiluted and this is where damage occurs.

If you are worried about your hair at the moment, it would obviously be important to find out which toxins are causing acidity in your body, but even if you don’t want to do this, at the very least start drinking good quality water. Increase your water intake every few days from 1 glass a day to 8 large glasses a day (approximately 2 litres a day). This helps dilute the acid in your body, no matter what has been causing the acid in the first place.
Drinking water is the first phase of detoxing. The second phase would be to take particular supplements (these are different for each person) which bind with the toxins and then take them safely out of the body. A hair sample test can establish exactly which supplements your body needs to carry out this conjugation phase of detox.

When you drink water, make sure the water is good quality. Filter it with a charcoal filter (Brita or similar) or have a water filter installed under your sink. If your water supply is fluoridised, I would suggest to drink bottled water as fluoride is not a great substance to have in your body. Don’t drink unfiltered tap water, no matter what your water company tells you. Chlorine in water needs to be filtered out, and your charcoal filter will do that for you.

Wheat and hair loss

Over 80% of my clients who have my hair/nail sample tests done have a problem with wheat. Some of them have a problem with all grains (rye, barley, oats etc).

Have a think about what you are eating for a typical breakfast, lunch and dinner. If your diet consists of muesli, sandwiches, pizza and pasta, this will have a major negative impact on your hair, even if you don’t have a wheat intolerance. What you need to eat is a little meat, plenty of vegetables and some carbs such as rice or potatoes. I know that this is inconvenient, especially for breakfast, but you are actually better off with bacon and eggs or an omlette for breakfast than with a muesli if you want to help your hair.

Foods you need to avoid are bread, pasta, pizza, biscuits, cakes, pasties and anything else that is made from wheat or gluten-free wheat. It is not enough if you change to gluten-free wheat as many people are not just intolerant to the gluten in the wheat but also to the rest of the grain.

Frequently Asked Questions:

Water:

Can’t I have juice instead of water?

Juice has a lot of sugar in it which makes the body acidic, and too much acidity is bad for your hair. Drinking juice also dehydrates you. There is really no replacement for water.

I find it hard to drink water. If I do, I have to run to the loo too often

Start with drinking sips of water throughout the day. If you need to pee a lot it means that you are completely dehydrated and / or that you are drinking too much too quickly.

Wheat:

I find it very hard not to eat pasta, bread and cakes. Do I really have to give them up for my hair to grow better?

I know it’s hard to give up wheat. Wheat is actually quite addictive, but if you want your hair back, you will need to at least drastically reduce your wheat intake. Wheat and other grains can actually stop the body from detoxing because they produce mucus in the body.

Is it OK to have glutenfree bread instead of normal bread?

Yes, gluten free is much better, but even that type of bread does not contain the nutrients your hair needs to grow, so make sure you have proteins and vegetables most of the time.

For more tips on hair regrowth, visit Vera Peiffer’s website: http://www.hairgrowthuk.co.uk/blog/ and read Regrowing Hair Naturally

More from Vera Peiffer

Principles of Hypnotherapy
What it is, how it works, and what it can do for you

Vera Peiffer

This is an authoritative introduction to hypnotherapy explaining what it is, how it works, what its origins are, what to expect when being treated and how to find a reputable hypnotherapist. It also clarifies how hypnotherapy can help with mental and emotional trauma, anxiety, depression, phobias, confidence problems and unwanted habits.

Click here to buy the book

Request a copy of the UK Singing Dragon Complete Catalogue

Singing DragonJanuary 10, 2013 6 Comments

Make sure not to miss Singing Dragon’s latest UK Complete Catalogue. If you have not yet received a copy, please sign up for our mailing list and we’ll send a free one out to you ASAP.

Readers in the UK and Europe who request a copy of the catalogue before February 15th, 2013 will also receive a voucher for a 15% discount on the entire Singing Dragon list of books, with free postage and packing.

Take advantage of this opportunity to find new, forthcoming and classic books on Chinese Medicine, Holistic Health, Taiji, Qigong, Herbal Medicine, Yoga, Spirituality and more. Also, sample health-promoting recipes with The Functional Nutrition Cookbook, and Make Yourself Better with Philip Weeks’ books. Delve into the history of Ayurvedic Medicine and the Mudras of India, and discover the Five Levels of Taijiquan, Daoist Nei Gong and Chinese Medical Qigong.

To request your copy of our Complete Catalogue, please click here. To receive your 15% discount voucher, please be sure to click the checkbox for “Singing Dragon” under area of interest or else mention this offer in the “any further comments” section.

If you have previously received a copy of the catalogue, and would like to take advantage of the 15% discount, please feel free to request a voucher via email at post@intl.singingdragon.com.

Singing Dragon attends Building Bridges of Integration conference in Chantilly, Virginia

sdusaOctober 31, 2012 0 Comments

Singing Dragon was happy to return to the Building Bridges of Integration for Traditional Chinese Medicine Conference in Chantilly, Virginia, from October 18-21. The warm temperatures made it feel like spring but with the beautiful foliage in full swing, fall easily gave itself away. The changing leaves were the perfect backdrop to this year’s conference theme: Transformation: Consciousness and Quantum Medicine.

Our table was busy with attendees who were happy to see Singing Dragon’s newest titles. These included I Ching Acupuncture by David Twicken, Acupuncture for New Practitioners by John Hamwee, Fire Dragon Meridian Qigong by Master Zhongxian Wu and Dr. Karin Taylor Wu and Illustrated Chinese Moxibustion Techniques and Methods by Professor Chang Xiaorong, Professor Hong Jing and Professor Yi Shouxiang. By the end of our first day we had even sold out of Frog’s Breathtaking Speech by Michael Chissick!

Attendees enjoyed discovering their Chinese animal and happily donned our pins inspired by Chungliang Al Huang’s The Chinese Book of Animal Powers. Attendees also stopped by to pick up our new title Mudras of India by Cain and Revital Carroll. Here Kate practices her Mandala Mudra.

During the conference we encouraged attendees to drop their business card into our bowl for a chance at a free copy of Chinese Medical Qigong. We are happy to announce that Deborah Waring of Lake Success, New York was the winner of this book. Congratulations, Deborah!

Using Shiatsu to Support Infant Development, Step by Step: An Interview with Karin Kalbantner-Wernicke

Singing DragonAugust 29, 2012 0 Comments

‘An important part of what we do is trying to put parents and baby in a different connection, where the parents are more aware about the needs of the baby – and also aware of their own needs.’

In this interview, author and Shiatsu practitioner Karin Kalbantner Wernicke recounts the travels through Japan that helped her to compile the techniques that form Baby Shiatsu, describing the very real benefits that these techniques can bring to parents and to babies from both Eastern and Western medical practice.

What is Baby Shiatsu and why is it so important for young children?

Baby Shiatsu is a special form of Shiatsu which really looks into the development of the baby from both a Western and Eastern viewpoint. It follows what we know about infant development from Western medicine, but we also use the Eastern viewpoint to look at how the meridians develop. When you use both approaches together, they give a more complete understanding of a child’s development, and of the interaction between parents and children.

It is also really important, in our opinion, that Baby Shiatsu supports the child at the stage they are at in the present, without any preconceived ideas of what the child should be doing either now or later on in life. When doing Baby Shiatsu, we are just thinking about what is necessary for the child now, and what a parent can do now to help their child take their next step in their own time.

Baby Shiatsu also offers so much support for the little daily problems – when babies are teething, when they can’t sleep, if they have gas. There are so many simple techniques from Shiatsu that parents can use to support their child.

How did you develop this approach?

That’s a long story! Many years ago I studied Shiatsu and I lived in Japan. While I was there, I was of course influenced by their approaches to health. After coming back to Germany I met my husband who had previously worked as a doctor in the Philippines. As he was also interested in Oriental Medicine we went together to Japan where he studied Shonishin (special acupuncture for children). I’m also a physical therapist, and my husband is a doctor, and we both specialise in working with children and babies.

When we were in Japan, we wanted to understand how all of these different therapies help children and babies – where they differ and what they have in common. So we travelled around Japan, we made a film, and we analysed what different therapists were doing and the impacts that these different techniques had. We also met families who used techniques passed from mother to mother to mother, through the generations. During this time, we discovered many techniques and views, and we put them together with what we already knew from theory and practice. You see, in Japan one thing that we saw was that sometimes, even though the techniques worked wonderfully well, the therapists themselves couldn’t explain why they worked. We, with our education in oriental medicine, modern physiotherapy and western development could really see how these varied approaches support one another, and how they work together. This is what Baby Shiatsu is based on, but it is growing year by year. New studies and observations continue to bring out new ideas and techniques, and we take this all in, as well as feedback that we get from parents and colleagues.

What are the changes that you see when you work with children?

You can see many changes – for example, when you do Baby Shiatsu in the hand and arm with a baby, suddenly the baby can develop a real consciousness of their hand – you see them realise ‘this is my hand!’

But what is really important for us is to teach parents to see what their baby or young child needs – when it’s time for a break, when it’s time to cuddle, when it’s just time to do nothing. When this baby becomes conscious of their hand, he or she needs time to lay there, to look at their hand, to touch their hand, whereas most of the time the parent just wants to go on. It’s difficult to understand when to slow down. Nowadays, parents want so much for their baby. An important part of what we do is trying to put parents and baby in a different connection, where the parents are more aware about the needs of the baby – and also aware of their own needs.

In your book you show that Baby Shiatsu can also be used to help parents support themselves – can you tell us about that?

There is a Japanese saying: ‘If you want to strengthen the baby, strengthen first the mother or father.’ When we are doing mother-baby shiatsu classes it’s very important to always work on the same developmental theme, or Qi flow, with both baby and mother. Nowadays, more and more fathers and mothers are coming together to sessions with baby and that’s great – it really supports the whole family and many of these techniques get great feedback from the parents. Parents can even use the techniques that we teach them on each other if they have any problems.

Baby Shiatsu is so simple to use, and because we don’t use oil and the baby remains clothed you can do it everywhere – if you have a few minutes to spare you can do it with the hands, or with the feet. It’s really very practical.

The cranio-sacral therapy spectrum

Singing DragonJune 18, 2012 0 Comments

By Thomas Attlee, founder of the College of Cranio-Sacral Therapy and author of Cranio-Sacral Integration

There are various approaches to cranio-sacral therapy, partly reflecting the development of the therapy over the years, partly suiting individual practitioners and differing styles. I see all these different approaches as part of a spectrum, complementary rather than antagonistic.

All cranio-sacral therapy is subtle. The spectrum ranges from the extremely subtle, with minimal physical input from the practitioner – an approach sometimes described as biodynamic, primarily concerned with creating a therapeutic space within which the forces of nature can enable profound healing, rather than actively doing anything.

The other end of the spectrum is still very subtle by any conventional standards, but may involve more physical input and intention from the therapist and a wider range of resources – an approach sometimes described as biomechanical (although the term mechanical is misleading in this context as it is not a mechanical process or even a particularly physical process, and is still a very subtle gentle energy-based approach).

The whole spectrum is valuable and all aspects of the spectrum can be integrated together for optimum effectiveness. This integrated approach is the approach that I teach at the College of Cranio-Sacral Therapy, and is the basis of the book Cranio-Sacral Integration.

The value of an integrated approach:

An integrated approach embraces the whole spectrum and enables the implementation of a wide range of resources, rather than laying down a particular method. The needs of each individual will inevitably vary and different circumstances will benefit from different responses. Just as a patient may sometimes benefit from orthodox medicine, osteopathy, homeopathy, or acupuncture, so within the field of cranio-sacral therapy, patients may respond to various levels of engagement and benefit from different aspects of the spectrum.

Cranio-Sacral Integration adopts an open flexible approach, developing a broad understanding of the value of different styles, and consequently providing the resources to respond effectively to each individual according to his or her needs.

Practitioner ‘presence’ is the key:

Ultimately, the most significant element in the therapeutic process is the ‘presence’ of the practitioner, the qualities that he or she brings to the therapeutic interaction. This is relevant for any practitioner, or doctor, or anyone working in health care, but it is particularly relevant in Cranio-Sacral Integration where we are working with subtle forces and quantum energies. The whole process of Cranio-Sacral Integration is an interaction between patient and practitioner, a process of entrainment, and the profoundly therapeutic presence of the practitioner plays a vital part in this interaction and in the therapeutic responses within the patient, and is therefore a crucial element in Cranio-Sacral Integration.

The way in which each practitioner develops these qualities is of course individual. There is no particular method that is suitable for everyone. But Cranio-Sacral Integration is much more than mere knowledge, technique and practical application. And the training in Cranio-Sacral Integration therefore involves, as a fundamental element, the development of these therapeutic qualities and practitioner presence, in order to enable the most profound healing of body, mind and spirit.

Developing habits to restore calmness: Qigong healing sounds for children and adults alike

Singing DragonApril 23, 2012 3 Comments

By Lisa Spillane, author and illustrator of Six Healing Sounds with Lisa and Ted: Qigong for Children.

The Six Healing Sounds teach children the calming benefit of pausing and using the breath to connect to the present. Observing the sensations of the body without thinking about the past or the future strengthens our awareness of the peace we have at the core of our being. In Qigong, negative emotions are not considered ‘bad’. Holding onto, cultivating and acting on negative emotions is when the ‘bad’ comes into things. Because negative emotions are part of the ego and have a role to play (mainly related to survival) it’s good to learn how to acknowledge them, listen to anything useful they are trying to communicate and then release the excess of them. Central to this practice is an acceptance that trying to resist, ignore or smother your feelings will only, in the end, make them grow stronger. Rather than letting negative emotions have the driving seat over your brain and body you can teach yourself how to regain calm.

The exercise that generates the most feedback from my book,
Six Healing Sounds with Lisa and Ted: Qigong for Children, is the one that helps children to stop worrying. Basically, worry happens when we meditate on fear, and being fearful gets in the way of clear thinking. When faced with a threat, the mind instinctively becomes more focussed on the urgent actions needed for survival and less inclined towards higher levels of thinking. This ‘fight or flight’ response far exceeds the requirements of our contemporary daily stressors. For children, things like spelling tests and unfamiliar situations and ideas can be interpreted as a ‘threat’, stimulating their adrenal glands and provoking biochemical changes in the brain that incline them to freeze, fight, hide or run. Over-stimulation of the adrenal glands takes its toll on the body, so it’s especially important to develop habits to restore calmness. Through a combination of smiling, deep breathing, visualization, positive thinking, gentle movements and sound-making Qigong breathing techniques help to reverse the body’s stress response and instead support its physical and mental well-being.

These exercises might seem strange when you first encounter them but there is a growing body of scientific research to support them. In my book, Ted overcomes his worries by doing the healing sound exercise for the stomach. The stomach together with the oesophagus, small intestine and the colon, make up what we refer to as the gut. We all know what it’s like to have ‘butterflies in the stomach’ and ‘gut feelings’, but it is a lesser known fact that there are about the same amount of neurotransmitters (one hundred million) in the gut as in the brain. These nerve cells communicate with each other via chemical and electric signalling, processing information and learning from past patterns. The healing sound exercise for the stomach helps children to establish healthy patterns for when they encounter worry. Instead of supporting an anxiety-driven chain reaction, they learn to pause, close their eyes, smile and breathe in the feeling of trust and openness into the belly. They think about their stomach smiling and filling up with a warm yellow light. Then, with eyes open, they exhale worry with a ‘whooooooo’ sound, imagining it leaving them as dark cloudy smoke. Doing this helps the brain and the stomach to calm each other down. Smiling produces serotonin and nearly all of that ‘feel-good’ chemical goes to the gut to help it with digestion. It also reduces cortisol, adrenalin and noradrenaline and it helps you to relax by getting the brain to release chemicals that not only make you feel happier, but support your immune system too. And, breathing deeply gives the brain a chance to see the broader picture, it’s calming and detoxifying and helps you to feel more positive.

Click to hear what the Six Healing Sounds should sound like!

Worry and anxiety is what keeps most of us awake at night. I know from personal experience and from the response of many of my readers that this practice works as well for adults as it does for children. I actually get a lot of adults telling me they’ve bought my book for themselves!

When you are doing this exercise, yourself or with a child, gently rub your stomach in a clockwise direction. Cast your mind on beautiful images of late summer (in Qigong, each organ is associated with a season) and as you smile, picture your stomach smiling too. Practising gratitude is medicine for the body and the soul so as you do this exercise, say ‘thank you’ to your stomach for all the hard work it does.

A little bit of time spent doing the Six Healing Sounds helps to promote relaxation both physically and mentally. It is also a great way to introduce children to the benefits of Qigong from a young age, and crucially, gives them tools to help themselves to deal with life’s challenges.

Join the Six Healing Sounds with Lisa and Ted: Qigong for Children community on Facebook!

“Although fatigue may persist, it can go away” – An interview with Lucie Montpetit

Singing DragonFebruary 20, 2012 3 Comments

Photo: Singing Dragon author Lucie Montpetit (Credit: Jackie Fritz)

Lucie Montpetit is an occupational therapist with over 25 years’ experience working in a variety of hospital settings. She runs workshops on managing fatigue, stress and pain using the approach she has developed incorporating a number of different techniques. She has personally suffered from debilitating fatigue and restored her health through the methods she now teaches others.

She is the author of Breaking Free from Persistent Fatigue – coming soon from Singing Dragon.

In this interview, Lucie recounts her personal experience with Myalgic Encephalomyelitis and how overcoming this condition through a combination of occupational therapy techniques and Eastern health modalities inspired her to help others to do the same.

Can you please tell us a bit about you and your personal and professional interest in improving the lives of people with persistent fatigue?

First, I’d like to explain that I chose the expression “persistent fatigue” because although fatigue may persist, it can go away. A frame of mind open to hope is important in healing.

When I started working as an occupational therapist, I was interested in understanding the drops in energy of my patients. Despite people’s motivation to get better, a lack of energy became apparent in rehabilitation. I encountered different types of lack of energy, whether patients were suffering from major depression in an acute psychiatric setting; war veterans suffering from late onset diabetes leading to leg amputation; or young mothers who just encountered their first major energy drop from multiple sclerosis or a rheumatoid arthritic attack. Personally, I went to see a neurologist at the age of 29 because of sudden energy drops and my GP thought I had multiple sclerosis, but nothing was found and it went away within two weeks. Then, after my second child was born, I had multisystemic symptoms that my GP did not understand. He said I must be stressed. But I did not feel I was more stressed than my co-workers and friends who had to conjugate career and family life.

Eventually, despite my relatively healthy lifestyle, I had to find another doctor who put me on sick leave with the diagnosis of myalgic encephalomyelitis. It took me about two years to recover from the persistent debilitating fatigue. After that I started to do workshops for patients suffering from similar daily challenges. My book reflects in part my own findings to regain my health as well as the work I have done as an occupational therapist with patients suffering from debilitating fatigue associated with different diagnoses. So it is not a book about disease but about finding solutions according to different ways of gaining back one’s physical, emotional and psychological energy balance. For many, it is also a path towards empowerment and finding a new meaning in daily activities.

Can you paint us a picture of what the person with fatigue goes through on a daily basis?

Once the imbalance is severe, here is what I observed in my patients: Sudden energy drops at fixed time during the day or after physical exercise; poor sleep of different kinds (inability to fall asleep, waking up many times during the night with an urge to urinate and/or unable to feel refreshed even after a good night’s sleep); food and environmental intolerances; exacerbation of known allergies or new allergy appearances; dizziness; mood swings; foggy thinking; no buffer to deal with stress; having a hard time doing little things around the house, such as washing dishes, due to lack of energy and reduced capacity to organise and plan; having projects in mind and interests to pursue but the inability to do so due to lack of energy; not being able to lift grocery bags without shaking like a leaf and needing to go to bed right after; preferring to be alone but not necessary being depressed – essentially just needing to use as little energy as possible to “survive another day”.

What causes this debilitating condition?

One thing for sure is that long standing exposure to stress is a cause of this debilitating condition, but not only psychosocial stressors like your work environment, a conjugal separation or the death of a close relative. These can also include viral infections, postural stressors that leads to jaw misalignment and lack of sleep, nutritional deficiencies that prevent the production of energy at the cellular level, candidiasis, and long term exposure to moulds, endocrine disruptors, heavy metals, allergens, electromagnetic smog and other environmental pollutants.

The accumulation of stressors leads to the imbalance of your psycho-neuro-immuno-endocrine (PNI) super system, known by researchers as allostatic overload.

What makes it worse, and what makes it better?

Continuous exposure to stressors of any kind – insomnia, not respecting one’s limitations and forcing oneself to do more – makes things worse. To make things better, get rid of the stressors when possible; eat energising foods rather than energy draining processed foods; modify daily habits to optimize the natural chronobiological hormonal cycles of one’s body; learn to change one’s mode of reacting into a more energising way of responding to daily life challenges; and make informed choices while honouring one’s strength and limitations. Choosing the right physical intensity of exercise to regain one’s capacities is crucial, while choosing key nutrients to optimise cellular energy production is also important in the process. Learning how to breathe efficiently through the nose in order to optimise the oxygen input is also very important.

What is the book about, and what motivated you to write it?

For many years, I have been dissatisfied with medical answers that purport to address the debilitating fatigue suffered by my patients with auto-immune diseases. Lack of resources and understanding, finding quick fix medications such as antidepressants for patients clearly suffering from musculoskeletal symptoms such as fibromyalgia, and having difficulty finding answers with the variety of health professionals I personally consulted inspired me to write the book. I needed to find answers firstly for myself, and then got the urge to share my findings and what I had learned with others facing similar prejudices among some health care practitioners. So the book is about finding personal solutions, different for each reader because of their own type of debilitating fatigue and personal way of over-spending their energy. People will learn how to make an energy balance sheet like one would do financially when consolidating debts. From their findings, they will figure out how to save energy in their daily lives and regain their inner mind-body balance towards health.

Can you talk about how your work and approach is influenced by Chinese medicine and other practices?

As an occupational therapist I was trained to view my patients from a holistic perspective, which is in accordance with my personal understanding. People require a meaning in the activity they are doing in therapy; they need goals of their own to reach in addition to those of my rehabilitation treatment plan for them. From my perspective as a martial artist of many decades, I am also influenced by the efficiency of energy expenditure, the need for the energy to circulate through the meridians and the influence of the breath during outer and inner Qi Gong and martial practice.

For me, the autonomous nervous system (ANS) follows the yin/yang principles. Patients I treat, for different reasons, have lost the balance of their PNI super system. This has direct repercussions on the ANS as it reverts to a constant “fight or flight” reaction mode as a result of too many stressors that leads to a narrow, skewed perception of daily life. In these circumstances, the ANS becomes too much yang.

I teach patients to reconnect with their bodies through their senses, the awareness of their body and posture in space and their breathing pattern. Then I use different Qi Gong exercises according to the level of energy of my clients or Chan Ssu Chin Tai Chi exercises (known as Silk Reeling Cocoon exercises) to reconnect further with their breath and body and the body’s ability to heal itself. Sometimes I use Neurofunctional reorganisation – Padovan’s Method® (NFR) with the patients to regain the balance of their autonomic nervous system and sleep rhythm: it is a powerful tool that follows brain plasticity principles. I had used NFR mainly with patients suffering from neurological conditions that follows brain plasticity principles in the past. Many of the NRF exercises help my clients suffering from debilitating fatigue as well because it helps reorganise posture, breathing, and ANS functions and rhythms.

Once the body starts to regain its natural rhythms, I encourage my patients to implement what they found useful in therapy into their lifestyle. I teach them about chronobiological rhythms so they can choose for themselves the minor changes in their daily habits that can help foster the natural flow of hormones and chi. Finally, when the patient starts to get out of the constant “fight or flight” mode and is ready to respond in a new way, I make use of Cognitive Behavioural Therapy (CBT) principles to help make changes to the energy draining perception of daily life to energising life habits that are better suited for the recovery process. All of those life changes follow the yin/yang principle to break free from persistent fatigue while restoring the inner balance called homeostasis in Western medicine.

How does the book reflect your general philosophy about health?

For me, health is a dynamic equilibrium within oneself. Equilibrium takes place in the physical, emotional, psychological and spiritual dimensions of our lives in relation to our environment. If a person is disconnected from one aspect of his or her self, the imbalance will eventually be reflected in the other dimensions of his or her life. I believe that every person who comes to consult me is in part responsible for restoring and then maintaining his or her PNI super system dynamic balance that we refer to as health. People are amazing at finding ways to change their lives in ways that make sense to them. Once they realise from a new point of view how they were living, they have no interest of returning to their previous lifestyle.

Our environment has never had such a strong negative impact on our health. Depleted soils and foods, pollution of all senses, the intrusion of technology in every aspect of our daily lives and having to deal with the compound effects of so many hundreds of chemicals even before we are born are also major stressors that health professionals too often neglect. These are also consequences of living in a world that is too “yang”. There is an implicit false belief that we have to be busy and multitasking most of the time. We can be proactive in maintaining or restoring our health once we gain knowledge of those relatively new phenomena. Knowledge is power. Feeling empowered rather than feeling a victim of a disease changes your outlook on your condition. This frees your body-mind and it starts to heal itself faster. Allowing a few minutes per day to be rather than to do is sometimes sufficient to maintain one’s inner balance.

Finally, how should this book be used by the reader?

The book is to be read and applied according to your level of energy. As a start, people who have low energy would benefit from knowing how to nourish their bodies to optimise energy production. Then they should go to the chapter that appeals to them. Usually, a gut feeling leads people to what they need. If a reader is too exhausted to concentrate on reading, I recommend bringing the book to a true friend or the health professional he or she is working with to do some of the exercises with the assistance of the health professional.

Managing stress and achieving balance through seated Tai Chi and Qigong exercises – An Interview with Cynthia Quarta

Singing DragonJanuary 23, 2012 2 Comments

Cynthia W. Quarta has taught martial arts for over twenty five years and was the Activities Director at an assisted living facility. She continues to teach seated Tai Chi classes in a number of locations to a range of ages and levels of physical fitness. She lives in Great Falls, Montana, USA.

In this interview, Cynthia talks about how she came to develop the exercises in her forthcoming book, Seated Tai Chi and Qigong: Guided Therapeutic Exercises to Manage Stress and Balance Mind, Body and Spirit.

Can you tell us a bit about yourself and how you came to practice martial arts in the first place?

I saw my first martial arts demonstration (jujitsu) when I was nine years old. I wasn’t able to take lessons, however, until many years later when one of my advanced ballet students asked to be excused from classes so she could take her black belt test. That was the first I had heard about her involvement in the martial arts. I offered to barter dance lessons in exchange for instruction in her style of Korean karate (Kwon Bup) to which she agreed. Shortly after that she began teaching several other classes in which I also participated. I finally received my black belt and, after my sensei moved out of town, opened my own dojo. Throughout the succeeding years, I had the opportunity to study Eagle Dragon Chinese Kenpo Kung Fu as well as a smattering of WuShu and Tae Kwon Do.

What motivated you to write this book, and what is it about generally?

While I was working as the Activities Director at a local retirement community, I used my dance and martial arts background to design an exercise program for the residents. When the community changed from one for able-bodied retirees to an assisted living facility for those with limited physical mobility, I had to change my approach. With the help of a core group of resident fitness enthusiasts, I developed a program of seated exercises based on the Yang style of T’ai Chi Chuan and the energizing exercises of Qigong.

This book presents a series of seated exercises to benefit people of all ages and levels of fitness. It is written for therapists and caregivers who want to provide an alternative, effective and creative approach to healing. The book includes instructions specifically for these health care professionals to assist them in their work with their patients/clients.

Why do the Tai Chi and Qigong exercises you’ve adapted in the book lend themselves so well to being practiced in a chair?

Both Tai Chi and Qigong are gentle exercise systems that provide healing and increase overall wellness. Regardless of a person’s situation – whether they are recovering from surgery, recently injured, elderly, or dealing with a chronic disability – these exercises are safe and yet amazingly effective. The emphasis in these exercises is on proper breathing and the involvement of the mind in the process of reducing stress, increasing energy and improving oxygen levels. For that reason the practitioner need not be in top physical condition or, for that matter, even able to stand in order to reap the benefits from the use of these exercises.

What positive effects can professionals hope to see in their clients and patients as a result of using the exercises?

The professional who uses this system with his/her patients will see immediate results in stress reduction, increased oxygen levels, improved appetite, more restful sleep, and a decrease in pain and stiffness. Mayo Clinic, Harvard Medical School and a number of other medical facilities with research divisions have published studies on the benefits of regular Tai Chi and Qigong practice. I encourage any health care professional considering whether or not to try this program to research these studies (most of them are conveniently available online).

Are there any common obstacles that professionals face when trying to guide their clients/patients through the exercise? How can this book help?

The primary challenge is the lack of knowledge and familiarity. Most of us in Western countries haven’t been exposed to Eastern medicine to any great extent. Overcoming the resistance to a new, holistic approach to improved health is usually the biggest obstacle at the beginning. As time goes on, though, and as patients begin to experience the benefits, their attitudes will change. This book contains a basic but inclusive explanation of Chinese medical theories to help professionals explain to their patients why these types of exercises can improve anyone’s level of health.

Why is it important to include a chapter on self-care for the professional?

If there is anyone who needs help in managing stress and achieving balance in their busy lives it is those who labor daily with patients who are ill or disabled! Therapists must be both relaxed and balanced in all areas of their lives if they are to help others achieve their wellness goals.

How does the book reflect your general philosophy about health?

I believe that an exercise program that works in combination with a healthy lifestyle and a well-balanced body, mind and spirit is the secret to a long and vigorous life. The exercises described in my book are gentle and safe and because they are designed to be practiced while seated, they provide a program that can be used daily even by those with physical limitations or of advanced age. In other words, this exercise system can be used throughout one’s life from youth through middle age and on into the later years, while at peak physical condition or at a stage of life when diminished mobility and strength present a daily challenge.

Compassionate care through touch – An interview with Niamh van Meines

Singing DragonNovember 25, 2011 0 Comments

Niamh van Meines is a nurse practitioner, currently self employed as a nurse consultant. She is also a licensed massage therapist, and a skilled clinical leader and educator in oncology, homecare, hospice and palliative care. Together with Barbara Goldschmidt, she has written the new book, Comforting Touch in Dementia and End of Life Care: Take My Hand.

Here, Niamh explains why touch is so essential to care.

Can you tell us a bit about the paths that led you to massage therapy, and to its applications in integrative health and palliative care?

I was a homecare nurse and wanted to offer therapy that would be comforting to my patients in ways that nursing did not routinely provide care. While massage therapy is within the scope of practice for nurses, I did not feel prepared to perform massage effectively, especially with patients who had chronic and terminal illness. I decided to go to the Swedish Institute of Massage Therapy and my interest in incorporating massage into nursing practice came from there. There are multiple studies that show the beneficial effect of massage therapy on the symptoms associated with disease, so I believe massage can be utilized as a symptom management technique. This is very useful in palliative and hospice care where multiple therapies, treatments and modalities are used to alleviate the distress that patients experience.

How did the new book come about, and what is it about, generally?

Barbara asked me to join her in writing this book as she had developed the hand massage protocol and implemented it in a nursing home. My expertise in hospice and palliative care and perspective on providing comfort for patients through multiple avenues resulted in a wonderful collaboration with this book. We both had an interest in providing ways for caregivers to help and to feel that their efforts are effective in providing comfort, so teaching hand massage to caregivers is a great opportunity to change not only the patient’s experience, but also the caregiver’s experience too.

How does the book reflect your general philosophy about care?

I believe that caring for any person who is ill begins with compassion which can be delivered in many ways. Touch is one of the most fundamental ways to offer support and caring and is often underestimated or disregarded in healthcare settings. Touch is often mechanistic and task oriented, so teaching healthcare practitioners to incorporate hand massage redirects their actions to that of a caring activity, which also has an affect on their perspective on helping to “heal”. A hand massage is a wonderful, easy introduction to using touch. From a caregiver’s perspective, they often feel disconnected from the person who is ill or weary of touching them, so it’s a wonderful way to approach the ill person and provide care in a manner that is satisfying to the ill person and to the caregiver, and safe. The hands are the most logical place to start as it often is the first place that we touch when communicating with and meeting people for the first time.

What are the benefits of touch as a way of connecting with people, as opposed to other methods of communication?

Touch can convey so many things that other forms of communication do not. Touch can be directed in many ways. It can have a calming effect or a stimulating effect that can be tailored to the goals of the touch experience. The hands are one of the easiest ways to approach someone; merely by shaking hands, you can have a dramatic effect. Touch can be more powerful than other forms of communication especially when someone is sick. Touch directed in a caring way can have more meaning than words, which makes it a useful tool when teaching caregivers to express through touch what they cannot often express through words.

What are some common obstacles people encounter when trying to use hand massage?

Caregivers often feel inadequate or unprepared to do massage. They have fears of being awkward or ineffective. They are not sure if they are doing it right. The beauty though, is that any touch whether awkward or not, can positively influence the giver and receiver. People often have difficulty slowing down and paying attention to energetic influences. This also comes with practice, so people need encouragement to keep practicing and over time, how they feel about the massage will change.

How can the book help caregivers overcome this and other obstacles?

This book touches on many areas that most people do not think about, especially from an energetic perspective and from an eastern approach to touch. It teaches people about the simplicity of touch and how it can have a dramatic effect. We hope that the framework in the hand massage protocol allows people to take the first step towards incorporating massage into their everyday caregiving.

This book can be used as a guide to doing a hand massage protocol. We encourage caregivers to have the book with them when doing massage, so that they can reference the steps and view the illustrations. It can also be used as a teaching tool in a classroom setting.

What are some examples of best practice?

Best practices always put the receiver’s needs first. Safety and comfort are a priority, so the giver must ensure the receiver is not suffering or in distress before performing massage. We also encourage caregivers to discuss the use of massage with the healthcare team to obtain permission, but also to find out if there are cautions and contraindications to massage. Because the receivers often have significant illness, it’s always best to err on the side of caution and pay attention to the receivers reaction to massage. This is truly a client-centered approach. And lastly, don’t take it too seriously. Massage should be light-hearted and friendly, an experience to be enjoyed not just by the receiver, but by the giver too.

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