Be Nourished

Perimenopause and Menopause, Midlife Metamorphosis

By Susan Buhler, MSOM, LAc

What is Perimenopause and Menopause?

Chinese medicine sees perimenopause and menopause as a normal and important transition, which can be assisted to proceed smoothly, quickly, and without discomfort. It is important to understand that it is a naturally occurring transition and is not a disease! According to Chinese medical theory, it is a transition that allows a woman to live in good health once past the reproductive years, and is the body’s wisdom of energy conservation.

Perimenopause is defined as the transitional time period in a women’s life prior to the cessation of menses. Perimenopause is often characterized by increasingly irregular periods, increased or decreased menstrual flow, emotional fluctuations, sleep disturbances, heart palpitations, digestive upset, fatigue, depression, anxiety, headaches, hot flashes, night sweats, and often an increase in any PMS symptoms that previously existed. On average, perimenopause lasts for 3-12 months as the ovaries decline in their reproductive functioning. There is no clear definition or time frame of perimenopause, as its duration and symptomology are very different from woman to woman -- influenced by genetics, lifestyle, general health and life stresses.

Menopause is the permanent cessation of menses and fertility and is defined as occurring 12 months after the last menstrual period. The average age of menopause is around 47 years old, but can occur earlier or later. Symptoms may include the above signs and symptoms, with some improving and some symptoms seemingly becoming more intense. Hotflashes, nightsweats, heart palpitations, changes in libido and emotional fragility are common symptoms for women as they enter into the menopausal/post- menstrual years -- as their bodies adjust to a new energetic balance.

Though there are common symptoms associated with perimenopause and menopause, from a Chinese medicine perspective, these symptoms are viewed as energetic imbalances in the body that need re- balancing. It is notable that these symptoms and many more are easily treatable by Chinese medicine.

Chinese medicine treats each woman individually, taking into account the whole pattern of each patient's physical and mental-emotional symptoms. Treatment may include either one or a combination of herbal medicine, acupuncture, and/or specific exercises or lifestyle recommendations. Stress levels, lifestyle, and general health are important factors involved in response time.

Gynecology is an area in which Chinese medicine truly shines. Its treatment is humane, without side effects, and can safely and effectively treat a wide variety of disorders. Chinese medicine may be used instead of or in conjunction with Western medicine for the successful treatment of perimenopausal and menopausal discomforts. There are many advantages to the use of Chinese medicine during this time of transition as well as for a variety of other women's health concerns. 

Please join me Wednesday, February 29th at Be Nourished from 6 to 7 p.m. for a free discussion:

Part 1:
Perimenopause & Menopause, Midlife Metamorphosis
Navigating the Transition to a New Beginning 

Step into your path...

Susan Buhler, MSOM, LAc has been involved in holistic healthcare for over 18 years and is a practitioner of Chinese medicine at Be Nourished. She incorporates acupuncture and herbal medicine, and has a specialized focus in women’s health care. She can be reached at 971-216-9913. More information can be found here.

 

Building Body Trust in Relationship

By Teresa Weis, LPC, LMFT

Often times we hear people talk about working on one’s self before getting into a new relationship. “It’s time to work on yourself!”, “I can really get strong and figure my stuff out!” or even most powerfully, “You can’t love someone unless you learn to love yourself first!”.  While it’s important to actively support anyone’s desire to do this work, this life is rarely black and white and/or absolute.  We can’t always plan when we fall in love, or when we meet someone of interest.  And even when we do all the independent growth work in the world, building our awareness and strengthening/shifting into new healthier patterns, inevitably we may find ourselves in another relationship and quickly triggered back into old unhealthy patterns of interaction and relating. Even in the middle of a long-term relationship, an aware life means that growth and change can happen at any time.  How does one build the skills of interdependence while in a relationship?  How can one strengthen one’s own self care patterns when deeply engaged with a loved one? 

Each of us brings our own history, beliefs, values, assumptions, meanings and triggers to a relationship.  Even when we find partners that share many experiences, beliefs, values in common, we may still feel challenged, especially in the course of modern busy lives, to do the hard work of creating the life we want within the context of an intimate relationship.  A couple’s level of cohesion, communication and secure attachment can potentially exacerbate the difficulties of maintaining a new pattern, especially when this new pattern involves one’s relationship to food, weight, and body image.  It is the people with whom we live that we will more often share meals, see naked, share physical activities, insecurities and health concerns.  Our partner’s beliefs about food, weight, and dieting can impact our feedback loops and those impacts can range from strong support to insidious sabotage.  It is easy to declare, “I will TRUST my body” and can still be hard to maintain if the meaning our partner’s derive out of that statement is a far cry from our own newfound body wisdom and awareness.  Stepping into the Intuitive Eating world, building body trust, and stripping away our old protective coping skills to reveal this deeper connection to our emotional lives and needs, can potentially complicate our feelings about our relationships.  Our partners may not know how to respond or grow with us, and it may reveal hidden tensions, surprising feelings, and or misunderstandings.  Even partners with the best of intentions may still find themselves on the outside of the partner’s process, feeling supportive yet disconnected.

As many know and have experienced, it is possible to change and grow together…even around deeply vulnerable topics with often disparate histories such as food and weight.  How do we invite our partners (often more than willing in intention) along with us on this journey?  How do we bridge the gaps in understanding and unpack the triggers each brings to the conversation?  How do we transform the fear of change and its associated losses into a powerful vehicle towards deeper intimacy and mutual understanding?  How do we ask for what we need in ways that neither require parts of our new self to disappear again nor sabotage our needs to be loved and cared for?

At the February Body Trust Network discussion on February 4^th we invite you to join us for a skill-building workshop that addresses these questions and concerns.  We’ll identify the strengths you and/or your couple already possess and expand the ways in which you make use of those strengths to deeper your mutual understanding and intimacy especially around food and weight.  Join us to really explore how body trust looks in the context of a relationship and how the relationship can blossom as a result of this shared journey.

 

 

Gentle Nutrition

A question I’ve been pondering since the New Year rolled around is “Why do people think they have to be ‘on a diet’ to eat healthier?  Why do we have to give up X, Y, and/or Z to make different food choices?  And why does the external structure of a diet feel more desirable than allowing your internal cues to tell you what to do?

When it comes to healthy eating, people believe they have to be perfect with food.  That healthy eating means no ‘this’ and never ‘that.’  This rigid thinking is hard to sustain, especially when we make so many decisions about food every day – when, what, how much, whether, etc, all day long. 

But people like to feel ‘in control.’  And if you’ve chronically been on a diet, it is hard to trust yourself to make the ‘right’ decisions when it comes to food. 

To reject the diet mentality, you have to recognize the damage that dieting has done. “If you allow even one small hope to linger that a new and better diet might be lurking around the corner, it will prevent you from being free to rediscover Intuitive Eating” (Tribole and Resch).  Dieting has eroded your ability to trust the choices that you make. 

We are all born with the natural ability to regulate our food intake.  Interference from well meaning parents, external messages from society and dieting behaviors disconnect people from it.  And people love to make healthy eating so complicated.

The truth is you do not have to eat a perfect diet to be healthy. You will not suddenly get a nutrient deficiency or gain or lose weight from one snack, one meal, or one day of eating.  It is what you eat consistently over time that matters.  Progress not perfection is what counts. (Intuitive Eating by Tribole and Resch)

Unfortunately, people are afraid to take risks with their eating.  Our clients love to think, talk and read about Intuitive Eating, but when it comes to experimenting with food choices they feel paralyzed. 

You cannot learn to play the guitar by thinking, talking and reading about it.  You have to pick the guitar up and play it.  And it doesn’t sound great at first.  But with time and practice, you get better at it.  This is what happens with Intuitive Eating.  Instead of think we made a mistake, we think “what can I learn from this experience?”

So what is one small step you can take to eat better?  Pick one meal or snack of the day and start there.  Over time, you will notice that when eating healthy tastes good and it makes you feel better, you are much more likely to sustain the changes you make.  Remember, this is about trying different, not harder!

The Fat Trap

By Hilary Kinavey, MS, LPC

An important article was published in the New York Times magazine on 12/8/11. In her article titled  “The Fat Trap”, Tara Parker-Pope asks if we have to be “superhuman to lose weight.” I urge you to take some time to read it, but then come back here. There is more to the story.

You see, I think the common response when we hear or read about the true metabolic realities of weight loss, is to feel pretty let down. You might feel worried about being stuck in your uncomfortable “fat” feeling forever. You might even be entertaining thoughts of self-blame about the size of your body. Or feeling more body shame, wishing so much that you could find a plan that would really work this time so you don’t have to feel these things again.

The good news is that you are not stuck just because dieting doesn’t actually work. It is so very important to remember that you manage to stay skeptical of most marketing ventures that are directed your way (of which there are many!) The dieting and weight loss industries, in all their various forms, make up a $60 billion dollar industry that is highly dependent on repeat customers. They know it doesn’t work either. They blame you, shame you and tell you that you aren’t trying hard enough instead. This tactic tends to trump our efforts at remaining skeptical of them. Doesn’t that make you angry? Allow yourself a moment of that. The fact that dieting does not work for your physical bodies is not new news. Linda Bacon Ph.D, the author of Health at Every Size, has researched weight loss extensively and has reported similar findings.

This is the time of year when the desire to make changes in the name of weight loss is the loudest and the marketing is the heaviest. It is incredibly easy to find yourself lost in the dominant thought process about weight loss. This thought process is something like “weight loss is important for health”, “the changes I make to my health behaviors must result in weight loss to be productive”, “ I have to change who I am from the outside in to be better” or simply, “Thin = health.”

This is where we find that traditional weight loss is not sustainable psychologically as well. We do not change from the outside in, but from the inside out. It’s tough to make big changes when we are afraid we are not good enough, even though we desperately might want to. These efforts also do not tend to be sustainable. We can
not shame ourselves into change. It doesn’t work. If it did, it would have already happened.

Carl Rogers reminds us, ““The curious paradox is that when I accept myself just as I am, then I can change.” It is inevitably true. If traditional weight loss doesn’t work, then we are left to deal with what is really happening in us, the real stuff that Brene Brown says “gets in the way.” We frequently know when making food choices what works for us and what doesn’t, but that isn’t what we rely on in that moment of choice. Other psychological factors come into play. We also know that a lifetime (no matter how long) of body dissatisfaction and dieting really skews our beliefs about food and self-care. We almost have to de-program that “dieting mind” to reconnect to our bodies again. It’s true…and it’s possible.

Hope is not lost. There’s a whole world out there that can support you in real and sustainable health practices. Our resources page can introduce to some of our favorites. And let us know about what you find on your journey.

So tell us, what did you think about “The Fat Trap” article?

Invest in yourself

By Dana  Sturtevant, MS, RD

With the holidays here and the New Year just around the corner, we are inundated with tips about how to manage our weight during the holidays and ads for weight loss products.  It is said that over 50% of New Year resolutions pertain to weight loss.  A recent blog titled A Year of Dieting states, “In the year 2012, Americans will likely spend more than sixty billion dollars on diets.  95% of those diets will result in people being as heavy or heavier than they started, with the medical dangers involved with weight cycling, and having taken the self-esteem hit of trying and failing at a diet.”  The author goes on to discuss the good this amount of money could do for the world.

In 2012, instead of pouring money into an industry that has to include the phrase “results not typical” anytime they suggest that their product might actually work, consider making a true investment in your overall wellbeing.  Instead of spending money on another weight loss program or a gym membership you are likely not going to use, consider these ideas:

• Clean out your closets. Give or throw away everything that doesn’t fit, is uncomfortable, or that you haven’t worn in years. Fill your closets with beautiful, comfortable clothing in your present size. If you need help, consider hiring a stylist that won’t tell you to lose weight to look good.  They’ll help you find clothes that flatter your body and make you feel great.  Imagine what kind of choices you might make for yourself when you feel so good in the body you have today.
• Find forms of movement that bring a smile to your face.  Let go of rules about what counts and identify joyful ways to move your body.  Look for dance classes, hiking groups, or other ways to spend your time.
• Take time on a day you don’t have to work to find a few recipes and make a plan for two or three meals each week.  Buy the ingredients on your day off so when you get home from work, you don’t have to think about what you are going to make.  You can pick the recipe that sounds the best and spend your time making a delicious meal.
• Make an appointment for a massage, facial or mani/pedi.
• Take a walk with a friend.
• Stop weighing yourself. Shift your focus from weight & body fat to healthy behaviors & fitness.
• Take a class you’ve always been interested in – photography, foreign language, gardening, stained glass making, etc.
• Seek support.  Consider finding a weekly support group that isn’t focused on dieting and weight loss.
• Take yourself out to your favorite restaurant for a romantic meal for one. 
• Take a trip to the Chinese or Japanese Gardens and journal/draw.
• Spend five minutes each morning and evening and write down at least three things you are grateful for.
• Start an art project.
• Buy art and gifts that celebrate your body.
• Plan a trip that you’ve always dreamed of taking.

There are many different ways you can invest in your health this year.  "The scale can only give you a numerical reflection of your relationship with gravity. That’s it. It cannot measure beauty, talent, purpose, life force, possibility, strength, or love. Don’t give the scale more power than it has earned. Get off the scale and live your life. You are beautiful!" (From a post on the NEDA Walk page)

So, how might you invest in yourself this year?

 

The Stages of Intuitive Eating, Part 1

By Hilary Kinavey, MS, LPC

The beginning stages of intuitive eating often require us to hold opposite experiences as truth at the same time. We can feel relieved and excited to have found something that finally feels right, new, and sane. We can also feel confused, alone and as if we are stumbling down an overgrown path with little information about what is to come.

Becoming trusting of and intuitive about your body’s signals and wisdom is a tall order when your body has been the place you have directed blame and self-hatred. Often, in order to get all that feels out-of-control back in line, the mind wants to make Intuitive Eating into the new Plan. Plans generally have to be done ‘just so’ and they are largely outcome (or weight loss) focused. When we are navigating the beginning stages of intuitive eating, the dieting mind/inner critic is always lurking, waiting for an “in”.

This challenge calls for a firm belief (that comes from you) about really and truly being done with dieting. This often involves reminding yourself over and over again of all the reasons you came to intuitive eating that don’t have to do with weight loss. What have you given up in pursuit of the thin ideal – joy, flexibility, spontaneity, friendships, a sense of self worth? Why are you truly seeking change for yourself right now?

The early stages of intuitive eating also call for you to investigate permission and pleasure with food. This can be truly scary if you have spent time trying to do food “right” (i.e. restricting) and then over-indulging in a flurry of self-blame and hatred (i.e. overeating or binging). People assume that “overeating” is about pleasure and indulgence. If we look a little bit deeper, we often find it is not. If you have used food to numb difficult emotions, then you have numbed ALL your emotions. You don’t get to be selective about this. Learning to heal your relationship with food to become an intuitive eater means learning to feel joy and pleasure again too.

Intuitive eating invites you to eat what you want. Even you if you have judgments about the food that you want. You then want to couple that desire with permission to eat and enjoy your food so you can actually have the eating experience instead of being distracted by shame and self-hatred every time you eat. It is here that you begin to connect with an internal voice that has been waiting to be allowed choice. This choice involves becoming more honest with yourself about whether or not you truly like the food you choose, and if you are really hungry for it and satisfied by it.

We will continue to explore how intuitive eating unfolds in real lives in future posts. In the meantime, tell us, what are the real reasons (other than weight loss) that brought you to intuitive eating?

Navigating Holiday and Winter Stress with Acupuncture

By Susan Buhler, MSOM, LAc

According to the wisdom of Chinese medicine, the cold months of winter are an essential time to conserve as well as generate vital energy – so that you may live and feel your best in all seasons…

The ancient Chinese believed that human beings should live in harmony with the natural cycles of the universe and their environment. The cold, quiet, stillness and darkness of the winter season urges us to slow down. This is the time of year to self-reflect, replenish energy and conserve strength. It is the time to integrate the life-harvest of this particular year, in preparation for a new cycle of life that begins each spring. It is also a season to go to sleep early, rest well, stay warm, eat nourishing foods, and expend a minimum of energy.

In Chinese medicine it is said that winter is ruled by the Water element, and is associated with the Kidneys, Bladder and adrenal glands of the human body. The Kidneys are considered the foundational source of all energy or “Qi” within the body. Once the daily energetic demands of the body have been met, if there is any Qi that is in surplus, it is stored by the Kidneys so that it can be used in times of stress and change, to heal, to prevent illness, and to age healthfully and gracefully.

While optimal health and well-being in the winter season calls for rest, nourishment and energy conservation for revitalization of body and spirit, your holiday activities may have a different agenda.

We have all felt the realities of holiday stress. The holidays can be filled with a dizzying array of demands: visitors, travel, frantic shopping trips and financial concerns. For many people it is also a time filled with sadness, loneliness, anxiety or even anger. Even under the best of circumstances, with all of these stressors on top of the ordinary and extraordinary demands of daily life, and you may find this to be one of the most emotionally trying times of the year.

Stress, anxiety and depression are our subjective experience in our bodies that energy is not harmonious and balanced. Such mental/emotional states can lead to a disruption in the flow of vital energy throughout the body. These energetic imbalances in turn can weaken the immune system, and cause symptoms including physical pain, sleep disturbances, abnormal digestion, headaches, and even menstrual irregularities. Over time, more serious illnesses may develop.

Chinese medicine offers safe and effective treatment to help smooth and balance our responses to what can be a challenging time of year. It can help correct energetic imbalances and directly affect the way your body manages stress. Thus enhancing the body, mind and spirit, one may face the demands of life and the holidays, with grace and vitality.

When the body’s energy is harmonious, the mind and heart are peaceful, and life is health.

For more information or to schedule an acupuncture appointment at Be Nourished contact:
Susan Buhler, MSOM, LAc
971-216-9913

Also, check out Susan's December Stress Release Acupuncture Special! For more info, click here.

The Honeymoon Phase

By Dana Sturtevant, MA, RD

I spent last week in Gainesville, Florida and had the great honor of meeting with Karin Kratina, author of Moving Away from Diets, a must read for any helping professional working with people to resolve their obsession with food, body and weight. I didn’t know about Karin’s work when I went to graduate school at the University of Florida in the late 1990s. I’ve always wanted to meet with her, and this trip turned out to be the perfect time.

We talked about all of the people who have influenced our work - Evelyn Tribole, Elyse Resch, Linda Bacon, Deb Burgard, Glenn Gaesser , Kristin Neff, and Brene Brown to name a few. When we got to Geneen Roth, Karin asked what I thought about Geneen’s recommendation to stop eating when you are at a 5 on the hunger scale. For those of you who are not familiar with our hunger scale (Hilary and I use Karin’s hunger scale), it is a 0 to 10 point scale with 0 being starving and 10 being stuffed. So eating until a 5 means you eat until you are at a neutral place (not hungry, not full). We both stated how surprised we were when we heard about this. Five doesn’t seem to be a very satisfying place to be at the end of a meal and we wondered how long people could really do this. She made the comment that anyone can undereat for a few weeks during the honeymoon phase, but after that, it has to get difficult for most of us.

Ah yes, the honeymoon phase. You might recognize that phase – the one when the diet is off to a great start, life seems grand, and we have renewed faith in our ability to lose the weight. Modern Family recently had a hilarious episode about the various phases Cameron goes through while on a juice fast to lose weight (watch the two minute clip). With any weight loss plan or program, there is the wedding, a honeymoon and then the real work begins – the marriage. And the farther we get from the wedding date (diet start date), the harder it is to keep the marriage (diet) going. People eventually cave and old behaviors and patterns are resumed. Sound familiar?  

Karin went on to say that in doing hunger work with clients for over 20 years, she’s found that everyone needs to eat until an 8 sometimes. For her, she’s noticed that she needs to eat until an 8 at least four times a week to feel satisfied and maintain a healthy relationship with food. A colleague of hers says she needs to eat until an 8 on the hunger scale once a day. This was interesting to me because most of our clients think eating until an 8 is something they should rarely, if ever, do. This information might encourage you to get curious about the hunger scale again. Maybe you’ll notice a pattern that seems to work for you too. After all, every body is different!

Nurturing Emotional Wellness with Acupuncture

By Susan Buhler, MOSM, LAc

 

At some point in life everyone deals with major upheavals or emotional distress. These events can trigger a host of unexpected feelings and behaviors - from depression and panic attacks, to major disruptions in sleeping and eating. The holidays in particular can be very challenging for many people who are striving to maintain emotional and physical balance.

 

From an Oriental medicine perspective, mental and emotional stress can cause a disruption in the flow of vital energy, or qi, through the body. This in turn may cause symptoms of depression, anxiety, pain, sleep disturbance, abnormal digestion, headaches, menstrual irregularities, and many more.  Additionally these energetic imbalances can weaken the immune system -- triggering frequent illnesses, or if under prolonged stress, more serious illnesses may develop. 

 

Chinese medicine is a powerful healthcare system that can alleviate and reverse symptoms associated with mental and emotional stress.  Acupuncture, of course, cannot remove the stressors that are inherent in our daily existence, but it can help moderate our response to various events and triggers by helping the body's energy be in greater balance. By doing so, the manifestations of stress and anxiety are lessened, and one feels calmer and has greater capacity for coping with the ordinary and extraordinary demands of daily life. When the body's energy is harmonious, the mind and heart are peaceful -- even during the holidays!

 

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As an expression of her continued commitment 

to sharing the benefits of Chinese medicine, 

Susan would like to extend a special offer to the Be Nourished community during the months of November and December in the hopes of bringing greater health and harmony to all of you.

For more information, click here. 

 

Susan Buhler, MSOM, LAc has been involved in holistic healthcare for over 18 years and is a practitioner of Chinese medicine at Be Nourished.  She incorporates acupuncture and herbal medicine, and has a specialized focus in women's health care.

Finding Your Voice

By Hilary Kinavey, MA, LPC

The process of becoming an intuitive eater can act as a powerful metaphor for understanding the places in us that scare us the most. When we learn to say “yes” or “no” to foods in response to a connection to what we know in our bodies, that same knowing begins to be available in other areas of our lives. These areas may have been long ignored, or under-explored simply due to the amount of time and space your worry and obsessive thoughts about food took up in your life. It’s a time when we begin to really see ourselves as whole for the first time in a long time.

When we are struggling to set boundaries in our lives and relationships, we are challenged to have boundaries with food. It just seems to work like that. When we begin to understand our body's requests and begin to have permission to enjoy food and stop eating food, then all of a sudden, we begin to seek and require boundaries in other parts of our lives.

The challenge here may be that eating and food have always stepped in when assertiveness and boundaries were actually what was needed. Many of us never really learned how to state our limits to the people around us, and food (or spending, drinking, etc, etc) supported us by creating a reliable, albeit temporary buffer between us and our discomfort in our relationships.

Learning to ask for what you need and feeling entitled to do so can be very intimidating because it may not be something you have had to do before. Many have stated that “it feels easier” not to, although it is clear that not having an authentic voice for many years has been far from easy. When our voices are diminished we lose connection to our innate joy, talents, wisdom and sense of place in ourselves.

In “The Dance of Connection” author Harriet Lerner suggests that the challenge “in conversations is not just to be our self, but to be the self we want to be. That’s why we don’t discover who we are by sitting alone on a mountaintop and meditating, or by being introspective and going deeper, as valuable as these disciplines might be. The royal road for discovering and reinventing the self is through our relationships with other people and the conversations we engage in.”

Not engaging authentically with the world from behind the mask of disordered eating is a powerful and creative coping method that was developed when needed the most. Stepping out from behind the mask of poor body image and dysmorphic ideas about your self is the way to heal all the way through. Brene Brown, a researcher who studies the impacts of shame, uses the following mantra to stay true to her authentic voice. “Don’t shrink. Don’t puff up. Just stand your sacred ground.” We are all entitled to take up space and use our voices to secure that space. It takes practice to really know this is true.