psychology Archives - Singing Dragon and Handspring Blog

Call for Comic and Graphic novel submissions

Singing DragonJanuary 22, 2015 0 Comments

Singing Dragon and Jessica Kingsley Publishers have recently started developing an exciting new line of comics and graphics novels and we are now open for submissions.

Singing Dragon publishes authoritative books on all aspects of Chinese medicine, yoga therapy, aromatherapy, massage, Qigong and complementary and alternative health more generally, as well as Oriental martial arts. Find out more on intl.singingdragon.com

JKP are committed to publishing books that make a difference. The range of subjects includes autism, dementia, social work, art therapies, mental health, counselling, palliative care and practical theology. Have a look on www.jkp.com for the full range of titles.

If you have an idea that you think would work well as a graphic book, or are an artist interested in working with us, here is what we are looking for:

Graphic novel or comic – Long form

We are looking for book proposals that are between 100 and 200 pages, black and white or colour, and explore the topics listed above or another subject that would fit into the JKP/Singing Dragon list. Specifically we are hoping to develop more personal autobiographical stories.

Here are the guidelines for submission:

A one-page written synopsis detailing the plot/outline of the book, as well as short bios of all the creators involved.
Character sketches of the main characters with descriptions.
Solo artist/writers or writer and artist teams should submit 5 to 10 completed pages to allow us to get a sense of the pace, art style and writing.
Solo writers will need to submit 10 to 20 pages of script as well as the one-page synopsis from point 1.

Comic – Short form

We have some shorter comic projects underway and are looking to expand the range of topics covered. These books can run from 20 to 40 pages, black and white or colour, with dimensions of 170x230mm. We are mainly looking for comics that provide ideas and information for both professionals and general readers.

For example, the first in this series, published by Singing Dragon, is a book exploring the latest developments in chronic pain research.

Here are the guidelines for submission:

A one-page written synopsis detailing the narrative style and subject matter to be explored in the book. Also include short bios of all the creators involved.
Solo artist/writers or writer and artist teams should submit 3 to 5 completed pages to allow us to get a sense of the pace, art style and writing.
Solo writers will need to submit 5 to 10 pages of script as well as the one-page synopsis from point 1.

When submitting please provide low-res images and send them, along with everything else, to Mike Medaglia at mike.medaglia@jkp.com

If you have any other ideas that don’t directly relate to the subjects described above but you feel might still fit into the Singing Dragon or JKP list, please feel free to get in touch with ideas and enquiries on the email above.

‘This slim volume deserves savoring’—One reader’s review of Archetypal Imagery and the Spiritual Self

Singing DragonJanuary 8, 2015 0 Comments

One reader’s review of Archetypal Imagery and the Spiritual Self: Techniques for Coaches and Therapists by Annabelle Nelson.

“This slim volume deserves savoring. What I mean is captured by these cherished words of a dying friend: ‘Must be present to win.’ Nelson’s book demands attention and rewards re-reading. She writes about intentionally seeking an expansive, wise mind. That search and its prize, she says, brings a fuller, quieting outlook on reality, access to previously locked energy, and greater capacity to perceive and achieve one’s highest goals. The method she advances is to thoughtfully select an archetype whose attributes or deeds appear somehow relevant to one’s current situation (a dilemma, perhaps, or a crisis). The next step is to bring the archetype to mind through imagination, using all of one’s senses and the guidance of a coach or therapist, the book’s intended readers as mentioned on the cover.

Our thoughts, feelings, judgments, and actions are already influenced by archetypes, Nelson says, but subconsciously, out of our awareness. They are denizens, one might say, of our hidden mind. Images and emotions are the language of this unconscious realm. When one engages the skills of imagining an archetype, that larger-than-life, mysterious, and possibly mythic being can become a focusing device to override the ego’s control of one’s rationality and open access to non-rational, even counterintuitive and frightening features of one’s psyche.

This coaching model assumes that humans have four bodies, the spiritual, physical, emotional, and mental, which is usually controlled by the ego. The ego is a positive part of human psychology, giving stability, organizing the personality and establishing a sense of self. But over time it becomes rigid, skewing perceptions and relegating uncomfortable thoughts and sensations to the unconscious. This is accomplished by eating up mental energy, and restricting both rational and intuitive thinking and emotional awareness. However, if one softens the ego and thereby the barrier to the other bodies, this in effect creates a more spacious mind. Information from the other bodies, emotional, physical and spiritual, can enter conscious awareness. (p. 182)

The tone of the book is both professional and personal; its material is presented as a synthesis of the understanding Nelson has derived from four decades as a psychologist, teacher, coach and spiritual seeker.

‘Looking at models of the mind both from Western psychology and Eastern religious philosophy gives some guideposts for understanding what happens when the conscious mind opens to the unconscious.’ (p. 28)

The result is a tapestry that shows as sometimes parallel, often coextensive, the paths to emotional health and to spiritual awakening. Nelson ignores conventions against treating in the same conversation these two subjects: one known through logic and the other through intuition. That is the power of this book. It is but an introduction—a handbook, even, for busy practitioners with clients to serve—to the idea that these knowledge fields share common ends and means.

Although I am interested in these subjects, I am unacquainted with present-day thinking and writing about them and am neither coach nor therapist. Nonetheless, I have gained greatly from the insights this book offers. It must be taken on its own terms. It abounds in metaphors. The proof is in the pudding. I have followed to surprisingly good effect the exercises and other aids Nelson provides. She makes no claims that her techniques produce overnight transformation. Anything but, really. As the stories she tells from her own life and the experiences of her clients illustrate, she’s all about the long term, about initially faint apprehensions ripening with familiarity into a new knowing.

In the creative process, the intuitive and rational are intertwined… The wise mind is spacious, allowing opposites to coexist. When logic is needed it can come to the foreground while intuition is in the background, or vice versa. Awareness keeps the space open for the interplay to happen. (p. 177)

Certainly, I carry from this reading a deeper respect for intuition and for using imagery to develop it. Another thing sure to be remembered from this book is the rich possibility of archetypes to reveal otherwise inexpressible truths.

The ‘spiritual self’ of the title has nothing to do with organized religion and none of the archetypes described are drawn from the Abrahamic traditions. Rather most of the illustrative archetypes pre-date and no doubt contributed to these traditions. Nelson invokes the Major Arcana from the Tarot (e.g., Fool, Magician, Chariot, Justice, Hermit) to speak of emotional development and ancient deities from Eastern mythology (e.g., Lilith, Isis, Gaia, Ganesha, Avalokiteshara) to explore spiritual development.

My favorite chapter is the final one, ‘What if Life Were Sweet?’ Of course its impact depends upon everything conveyed in the preceding chapters. Here is a brief excerpt:

Opening the mind to wisdom is not an easy task. It is a complex and simultaneously subtle endeavor. The ego’s hold on stability is sacrificed for the connection to spirit that brings peace and joy. The delusion of control and separation erodes to a softer, warmer and friendlier awareness. The sense of Self is not constricted to fragmented thoughts or overwhelming emotions. Trust doesn’t rest with control of the inner world, but with the sense of interconnection. Stability comes from a focus of attention, not from a defensive posture.

There is a theme in both the deity and tarot archetypes. Almost all of them face a crisis. Lilith is thrown out of Eden. Isis’ husband is taken and murdered. Avalokiteshvara loses his faith and his brain is shattered, while Ganesha’s head is cut off. These deities became powerful in the face of despair, pain, grief and rejection. The world they inhabited ended in some way, and survival depended on adaptation to tap the power inside to become wise. The unconscious not only contained their fears, but also hid their strengths. When the unconscious is opened, hidden strengths are apparent. An individual is essentially changed from the inside out since there is more energy and power. (p. 181)”—Michele Minnis, PhD

Michele Minnis, PhD, is retired from a career at the University of New Mexico, where she of taught legal and expository writing, did research on cross-disciplinary collaboration, and served on the founding faculty of a master’s degree program in water resources management. She and Annabelle went to graduate school together at the University of Kansas, Department of Human Development.

For more information or to purchase a copy of Archetypal Imagery and the Spiritual Self, click here.

Improve patient’s experience through relationship-building – interview with Jane Wood

Singing DragonAugust 28, 2014 0 Comments

Jane Wood has been involved in reflective practice for the last 20 years. She is a supervisor and teacher of reflective practice at the University of Westminster and is the head

of practitioner development and reflective practice at the International School of Homeopathy, London.

Jane Wood’s new book The Compassionate Practitioner is now available from Singing Dragon. This handbook, full of practical tips and supportive advice, explains how best to enhance the client’s experience through compassion and mindfulness. This book will be a valued support for anyone working in private practice.

What inspired you to write this book?

I have been teaching the practitioner-patient relationship to students at college and at the University of Westminster for nearly 20 years. At the same time, I have been supervising qualified alternative practitioners and seen their struggles to build up a private practice. Many practitioners talked about the same issues in supervision: their patients were demanding, impatient or simply didn’t return. The practitioners needed to find a way to create trust, loyalty and staying power. They could do this if they improved the patient’s experience during the consultation. I realized I was in a position to write a book that takes the practitioner through every stage of the consultation, giving them lots of practical advice on how to create a healing relationship with the patient – and gain a flourishing practice.

Why is relationship building so important for people working in private practice?

I strongly believe that relationship building is vitally important for everyone in the caring professions whether they are alternative practitioners, counsellors and therapists or traditional doctors, nurses and consultants. Unfortunately, most orthodox practitioners do not have the time available to do much relationship building, leaving both the practitioner and the patient feeling dissatisfied and rushed. Many alternative practitioners such as homeopaths, acupuncturists, and body workers have longer sessions with their patients, which allow them more time to work on the relationship.

On the surface, making an effort to improve the experience for the patient will increase their trust and loyalty to the practitioner, but it is more than this. When the practitioner takes time to make the patient feel safe and appreciated, the patient can start to relax and explain themselves better; which in turn enables the practitioner to give a better treatment.

The added bonus for anyone in private practice, is that once there is a good relationship, the patient will help build up the practice by referring other people.

There are many different ways in which the practitioner can improve their patients’ experiences. One way is consider the clinic environment. I suggest that practitioners take five or ten minutes to sit in the patient’s chair, quieting their mind by focusing on the breath. Once they are quiet and relaxed, they can bring themselves into the present moment and use all of their senses to assess the clinic room. What is the feel of the chair they are sitting in? Is it comfortable? What is the room temperature? What smells are there? Can they hear the receptionist or another therapist working in the next room? If so, does this impact on confidentiality?

What can practitioners do to improve their patients’ experiences?

The appearance of the room will make a big difference to the patient. If the practitioner is behind a desk they will feel more secure, but the patient will feel distanced. What do the patient’s eyes rest on when they are not talking? Considering the clinic room through the senses will give the practitioner a taste of what the patient experiences. They then need to consider what they can do to improve the current environment.

Another suggestion for improving the patient’s experience is that the practitioner should explain to the patient what will happen during the consultation. This is called ‘signposting’ and should be done at the beginning of the session. It can be very brief, such as, ‘I’m going to invite you to talk about yourself and your problem for the first twenty minutes, and then I’ll give you a treatment which takes about thirty minutes. You’ll need to take off your shoes and get onto the treatment couch. After the treatment we’ll see how you feel.” Once this has been clarified, the patient knows what to expect and can relax.

How can practitioners maintain balance in their work and avoid burnout?

Being a practitioner and listening to many patients talking about themselves is a great privilege and helping them can be deeply rewarding. But sometimes the price is too high. There are several different causes of burnout, including working for very long hours, anxiety about patients or unconsciously taking on the patients’ negative emotions. The last one occurs mainly when there is a long time spent face-to-face with the patient, such as for counsellors, therapists or homeopaths. Our brains are programmed to read other people’s body language and facial expressions, so that we can empathise or feel their emotions.

The patient’s emotions can be directly experienced by the practitioner who might carry home a patient’s anger or depression. An awareness of this will help them consciously make more breaks in eye contact, and change their own body language more often so they don’t unconsciously mirror the patient so much.

Another way to avoid burnout is to make sure the practitioner has enough personal time to have fun and relax. This might sound obvious but when a single practitioner is running a private practice, they have to be their own marketing manager, record keeper and accountant and this all takes time. The practitioner needs to balance the intense work in the clinic with care for themselves, physically, mentally and emotionally.

You write a lot about self-reflection. Who do you think should do it and why do think it’s important?

Self-reflection is a process of self-examination, of thinking seriously about your own character or actions. In the caring professions this will mean exploring something about the practitioner-patient relationship in order to understand it in more depth and decide what can be done to improve it. It is not nearly as effective if it is done within the limitations of the practitioners mind, and much better if it’s done out loud in front of a colleague or supervisor, or written into a self-reflective journal. If something went well, the practitioner can make a note of it so that they can repeat it. If it didn’t go well they can analyse why and plan how to change things next time. As I see it, all practitioners should be doing self-reflection. Their learning taught them how to work with the average patient. Experience shows them that patients are anything but average and everyone is very different. Self-reflection raises the standards of the practitioner and everyone gains from it: the practitioner, the patient, the clinic and the profession in general.

Books for Mental Health Awareness Week

Singing DragonMay 14, 2014 0 Comments

Mental health awareness week is a great time to look at how natural therapies can complement mental health treatment and be fundamental to keeping the mind healthy and preventing problems in later life. Here is a selection of some of Singing Dragon’s books for improving mental health.

Recovery and Renewal by Baylissa Frederick

Many people will be perscribed medication at some point in their lives to help with a mental health issue, but they can lead to dependency and coming off prescription drugs can be one of this most challenging parts of maintaining mental health. This book will be a lifeline for anyone taking or withdrawing from sleeping pills, other benzodiazepine tranquillisers and antidepressants. The author draws on her personal experience of coming off benzodiazepine tranquillisers to explain everything you need to know about withdrawal, including how to identify symptoms, manage them, and take firm steps towards recovery. It’s an uplifting, empowering read which will also be useful to families and friends of people overcoming perscription drug dependency, as well as medical professionals.

Managing Depression with Qigong by Frances Gaik and Managing Stress with Qigong by Gordon Faulkner

These two practical books give step-by-step instructions for Qigong forms designed to combat depression and stress. No previous experience of Qigong is necessary. Frances Gaik is a clinical professional counsellor and provides a treatment plan with helpful advice from her years of practicing Qigong and meditation in therapeutic settings. Gordan Faulkner is Prinicpal Instructor at the Chanquanshu School of Daoist Arts. His anti-stress exercises are designed specifically to fit around a busy lifestyle and have been extensively trialled with Maggie’s Cancer Care Centres.

The Mystery of Pain by Douglas Nelson

This is a personal tutorial for understanding the psychology of pain. Douglas Nelson takes an in-depth and surprisingly entertaining look at how we experience pain and what medical professionals and therapists can do to improve treatment. Through asking strange questions like ‘Why does scratching an itch feel so good?’ and ‘Why is pain from a mosquito bite preferable to the same pain from an unidentified source?’ Nelson shows how us that the more we understand pain, the more power we have to control it.

Fragrance and Wellbeing by Jennifer Peace Rhind

Fragrance has a powerful impact on our mental and emotional states, with scent playing a key role in forming memories and sense of place. This book explores the impact of fragrance on the psyche from biological, anthropological, perfumery and aromatherapy viewpoints. The author explores how scent has been used throughout history and across cultures, discusses the language of fragrance and presents detailed profiles of a broad range of fragrance types including their traditional and contemporary uses, and mood-enhancing properties.

Principles of EFT (Emotional Freedom Techniques) by Lawrence Pagett and Paul Millward, and Principles of NLP by Joseph O’Connor and Ian McDermott

These are quick and easy introductory guides to teaching yourself the therapeutic psychological techniques of EFT and NLP. EFT (Emotional Freedom Techniques) work by removing blockages in your body’s energy using tapping in order to feel more positive, energetic, and less stressed. EFT can relieve a wide range of conditions including anxiety, anger, depression, insomnia and migraines. NLP (Neuro-Linguistic Programming) is a system of modelling your speech and behaviour to achieve your goals and connect better with those around you. It’s applications include building confidence, beating depression, and developing your career. NLP is a great starting point for anyone looking to improve their life.

Mental Health Awareness Week runs from May 12-18, for more information see www.mentalhealth.org.uk. For more books on a range of mental health issues visit Singing Dragon’s parent company, Jessica Kingsley Publishers, www.jkp.com.

Raise awareness of Ehlers-Danlos Syndrome this May

Singing DragonMay 21, 2013 0 Comments

May is Ehlers-Danlos Syndrome (EDS) Awareness Month, raising awareness of this multi-systemic and complex connective tissue disorder, and supporting those who live with this invisible condition.

As awareness and understanding of EDS are central to early diagnosis and management of symptoms, take the time to learn about the condition, and simple steps that can help the many people who live with it.

Learn more about EDS (especially type III – Hypermobility Syndrome) with these interviews and resources, and more:

Books:

Interviews:

Organisations:

See also:

A Guide to Living with Hypermobility Syndrome (Facebook)
A Multidisciplinary Approach to Managing EDS Hypermobility Syndrome (Facebook)

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.

The Enneagram of Personality – From Psychology to Spirit

Singing DragonNovember 15, 2012 0 Comments

The Enneagram of personality is an ancient, beautifully accurate, spiritual and psychological model of humanity. Describing nine personality types and their interactions, it enables us to look deeply into our own character, harmonise our daily lives and our relationships both personal and professional, and understand our personal path to growth.

First described in the West by Gurdjieff, the Enneagram’s particular nine-pointed star is an ancient diagram, though no-one knows its origin. Not an arbitrary shape, it encapsulates the esoteric Laws of Three and Seven (octaves), is very like Pythagoras’ ninth seal symbolising humanity, and some researchers link ancient stone circles with the mathematics of the Enneagram.

Sufis have called the Enneagram ‘a God-given tool for personal moral healing’. A conversion concept including the diagram and nine personality types has been part of Sufi ethical training for 1400 years. Christian mystics of the Desert Father tradition, in the third and fourth centuries, worked with the concept of converting vice to virtue, using the personality traits now named in the Enneagram. It seems to be a wisdom which surfaces when and where it is needed – and in surprising ways – as of course all spiritual truths do.

The Enneagram describes, amazingly accurately, nine distinct personality types, their variations, and the spiritual states of being with which they are linked. Furthermore, the flow of connecting lines shows the inter-relation between different aspects of each personality. At first it may be hard to identify our type: unlike other typologies, Enneagram type is defined not by behaviour but by something which is so fundamental to our personalities that we may not be aware of, or may actively deny, it.

The central premise is that each of us has one of the nine possible ‘chief features’, a focus of attention so deep it is usually hidden from our conscious awareness, which sets the tenor of our whole lives. Originally a way of coping with the outer world, by the time we are adult it is an automatic biased perspective (the ‘false self’). The key words are ‘passion’ – through which we focus on the world emotionally – and ‘fixation’ – our mental focus. In the grip of our passion/fixation, behaviour is automatic and often harmful to our true well-being, though it was originally developed as a protection.

The beautiful part is that this ‘false’ personality shows us our own spiritual path: not an enemy to be conquered, but our best friend, showing us what lessons we need to learn and how to learn them. The different passions and fixations developed to protect their ‘holy opposite’ (Holy Virtue and Holy Idea), which were ‘forgotten’ as ego developed, and to which we long to return. They are mimicked as well as masked by personality.

Linking personality type to spiritual potential in this way, the Enneagram makes it possible for the first time to bridge the gap between psychology (who we are not) and spirituality (who we truly are): a continuum of healing growth.

All mystic traditions recognise three ‘organs of perception’. When unconscious the head produces fear, the heart yearning, and the belly anger. The nine Enneagram types are variations on these three basic emotions: according to our type, one of these is the ruling ‘negative’ emotion, whether we are aware of it day-to-day or not.

The central triangle of the Enneagram shows the core personalities of each centre. It also represents the trinity of Hope (3), Faith (6), Love (9), and would teach us to open all three centres.

I am often asked: ‘When I know my type, what then?’. We start with the personality. According to the Enneagram the resentments, desires and fears that go to make it up are actually distorted expressions of the energy one works with to get to the higher states.

Working with the Enneagram, with myself and clients, I have found it more creative to recognise your passion, put your attention on it, learn to observe it and see what it teaches you about yourself. Part of this learning is in meditation, developing a strong inner witness (that part of ourselves which is not our personality), and part in simple day-to-day self-observation.

This process itself loosens the grip of the automatic response: it also gives insight into how to work with our issues. Different issues define each personality type, and the same strategy for emotional, psychological and spiritual growth doesn’t work with all types of people. So the first step for all types is to observe the underlying placements of attention that support repeating behaviours and emotions.

Finally, though we are all capable of feeling all human emotions, we actually experience life in radically different ways, and have vastly different responses to events, even to conversations. The Enneagram, like any personality typology, can be trivialised. Though this cannot be helped, I trust that its real meaning will survive through those who recognise its spiritual origin. Studying your own and others’ types fosters skilful living, personal growth, better relationships, a deeper understanding of all humanity, and ultimately, despite our different personality types, the experience that we all are one.

Karen A Webb has been teaching the Enneagram in the Narrative Tradition for over 20 years. She graduated from the Enneagram Professional Training Program in 1991 and now runs Enneagram Studies UK, providing open and tailored Enneagram workshops and consultations. Karen is a passionate, lifelong student of spirituality, comparative religion and psychology and lives in Malvern, UK.

“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.

Bending without Breaking – Author Isobel Knight talks about dancing and living with Hypermobility Syndrome

Singing DragonJuly 5, 2011 4 Comments

Isobel Knight is a dancer who has Hypermobility Syndrome (HMS). She completed her MSc in Dance Science at the Trinity Laban Conservatoire of Music and Dance in 2009, and now works as a Manager in the clinic there, also giving lectures on HMS from time to time.

Here she answers some questions about her new book,
A Guide to Living with Hypermobility Syndrome: Bending without Breaking.

How has Hypermobility Syndrome shaped your life as a dancer?

I did ballet from the age of five and loved it straight away. I saw my first Nutcracker at age seven in London for my birthday treat, and remember watching the dancers on pointe and thinking I would really like to do that. I got the book, Life at the Royal Ballet School by Camilla Jessel as a Christmas present in the same year, and was fascinated by the training the ballet dancers had to go through, and their very obvious dedication. That book is still one of my favourites. I would still love more than anything to go and spend a few days at White Lodge watching the dancers learn.

My dancing career has been very ‘stop-start’. I danced from age five to nine and only got to Grade 1 level and then stopped owing to a change of schools. I then started dancing again at the age of 13 and all my former classmates were in either Grade 5 or 6. I had a lot of catching up to do, but really relished the challenge. I remember when I had not long been back that one of the girls in my class said to me, “you’ve got lovely turn-out, you are so lucky.” And I was. And I am, largely due to my having Hypermobility Syndrome (HMS) which means I have a larger than normal range of movement and, in dance, allows me to achieve positions that most other ‘normal’ people find too stressful on their bodies. In many ways I have a good body for classical ballet (except I am not a size 8, and tiny and petite). I have very good rotation at the hip because of my hypermobility. I have good strong feet (not always in keeping with some hypermobile people) and a pleasing arch of the foot, a flexible back and good extensions. I was also aware early on that my legs were what my teacher called “swayback”, which was another aspect of hypermobility, and my legs were and still are an interesting shape because of knee joint hypermobility and this is desirable in ballet for additional leg extensions.

However, despite my hypermobility being an advantage to me in some ways, interestingly, my coordination isn’t very good and, while I did well in classical ballet, I failed miserably at sports. Impaired coordination is another common symptom of hypermobility. This means that sometimes it takes me longer than others to learn new movement patterns. And because of the larger range of motion, there is always so much extra to manage and control for the hypermobile dancer.

When I re-started ballet at 13 I had a lot of catching up to do. I would often attend the classes of the younger children and stand at the back so I could learn all the steps I had missed since giving up at age nine. When puberty hit, many of my classmates gave up ballet as their bodies tightened up and they were struggling with their own lack of turnout and the demands of the higher grades of the syllabus. I, on the other hand, was coping very well with the changes in my body – aside from growing pains and a very regular calf pain and cramp, which was so severe I often couldn’t walk normally first thing in the morning! These were probably the first signs of HMS, but I had also broken my leg when I was seven and have never walked properly since that time, walking far more like a ballet dancer than a ‘normal’ person.

Just after I finally took Grade 6 and Pre-Intermediate exam, just weeks prior to my 18th birthday, I started to get lower back pain. At first my teacher and I thought that I had overdone things, but after it had persisted for a few weeks – mainly being painful in positions such as arabesque – I was sent to my GP and I had my first sessions of physiotherapy which did briefly improve the pain. Unfortunately it never went away entirely and I battled on with this until I was 23, having had more time out of ballet owing to university. I then took my Intermediate (Vocational Grade Examination) and had a year of doing Advanced Level 1 ballet before the pain took its toll. I reluctantly decided that I had better stop as I thought the dancing must be exacerbating my back pain.

Tell us about your diagnosis – did it help you

Following an eight year break from ballet, I took it up again after attending a pain management course where I learned that “pain didn’t always equal damage.” By then my back pain had been diagnosed as related to a disc prolapsed at L4/5 and disc degeneration. The reason for the pain would have been caused by hypermobility at this section of my spine and a complete lack of muscular strength to control it. The disc diagnosis is very much secondary, I believe. The pain management course incorporated exercises and stretches to recondition our de-conditioned bodies and psychological strategies including pacing activity and goal-setting. Upon discussion with the doctors and physiotherapists at my pain management course, there was universal agreement that I could return to doing classical ballet; that it would not be detrimental to my back pain providing that I paced my return to class very carefully.

I started to do syllabus classes with a local dance school in my area in South London. This was in late 2006. I was very frustrated initially because my brain remembered how to do the steps, but my physical body found it very difficult. I stopped again in 2007, dancing from the privacy of my flat, and then started to do classes at Danceworks in Central London, which are open classes of many levels. I started doing a class where I knew the teacher, but kept on injuring my calves. From late 2007, I went on a diet and started to lose much of the weight I had gained owing to my complete inactivity. As I started to feel better in myself, I started to do more and more classes, even though I wasn’t really ready for this, and in February 2008 partially tore my right calf muscle. However, this for me was not the end of ballet, but just the beginning of a very long journey to recovery, as it turns out, at the mercy of HMS, which was diagnosed in 2009.

We were doing some testing for dancers at Trinity Laban and this was the first time that I seemed to fit into the category of potentially having Hypermobility Syndrome. Very shortly after that my physiotherapist (Katherine Watkins) suggested that it was very likely, but of course the ultimate diagnosis comes from a Consultant Rheumatologist.

When I received my diagnosis I was initially quite upset because I really didn’t want this ‘thing’, and just thought I was very flexible. But the more I started to find out about the condition, the more it was obvious as to why I had so many problems all my life – e.g. walking late, being clumsy and having poor coordination, regularly injuring myself and then ending up in constant pain. I then pieced other related syndrome features such as having fatigue, asthma, IBS, and it all begun to make sense.

What is your day-to-day life like with HMS?

I have to think through the results of my actions and normal movement that other people would take for granted can have huge repercussions for me. For example, just doing too many reps of an exercise can cause overuse injuries and induce serious fatigue very quickly. Lifting my nephew too many times fatigues my arms and shoulders to the extent I can hardly hold a newspaper the next day.

The fatigue combined with the pain have also meant that I am often just too tired and have no energy to manage socialising and going out at the end of the working day, resulting in my cancelling social events often. It is very difficult – and I have let many friends down – but luckily most are tolerant and are usually understanding.

How did the book come about – what motivated you to put pen to paper?

I think I was fed up with having to explain to people constantly why I was always getting injured and was so often in pain. I felt that there was an essential need to tell my story and explain, through the eyes of a person with HMS, just how insidious and multi-systemic this condition is.

I also felt there was a need to justify my symptoms and show that that neither myself nor other HMS patients are hypochondriacs – that the pain, fatigue, and constant injury are real aspects of the condition. So I wanted to write the book to support other HMS patients, but more than anything else to try also to educate medical professionals and explain to family and friends just how difficult this condition can be to manage. I also identified a gap with respect to patient-led literature on the subject; other sufferers told me they really wanted to try and write about their experiences but often got too fatigued in the process, something I can very much identify with!

What is your outlook for the future as a dancer with HMS?

I think that subconsciously I knew that I would never have a career as a dancer (with or without the HMS). I never really enjoyed performing as a dancer, (although as a musician, I do!) and just knew I didn’t have the right physique for classical ballet. I think I knew that I would love a career that involved working with dancers, so I have managed that successfully in working therapeutically with dancers, as well as my work at Trinity Laban as the Clinic Admin Manager.

I have always loved the discipline and structure of classical ballet classes. My body knows how to do most of the movements, and it has always felt “right” for my body. Since I have now been through an extensive physiotherapy rehabilitation programme which is likely to have to continue in a maintenance capacity forever, I think that my chances of safely continuing classical ballet classes for a much longer period are more likely. Indeed, I hope I will still be doing ballet when I am an old lady! If I keep matching my strength to my flexibility, and listen to my body when it is too fatigued to dance safely, there is no reason why this shouldn’t be the case. Exercise is a crucial aspect to the management of HMS, and what better exercise than classical ballet, where being hypermobile is a natural and aesthetical asset. Finally, having the eye of a good ballet teacher is absolutely essential, and the support and guidance of a expert HMS physiotherapist. Without these two I would have more difficulty in continuing to pirouette in safety!

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