How to self-publish a work of non-fiction; pitfalls and handy tips

This year 2015 is the year I wrote my first book - a work of non-fiction entitled Stress, Trauma and Unresolved Emotion in Chronic Disease. It was, to my knowledge, the first time that someone has addressed the biochemistry, physiology and psychology together in one book reflecting my personal interests. I started research formally last September, and completed a 'how to write a book course' which , although giving me some useful tips, turned out to be a bit out of date and more geared towards those who want to get a publisher, whereas I wanted to self-publish as I knew I could get it out quicker.

1. Writing the manuscript
   I used Word which I know is not what professional writers use, but once you set up a Styles template makes producing an index (aka Table of contents or TOC) much, much easier. You can also move parts of your document around by looking in Outline view so you don't have to scroll through thousands of words.
   
   I was told that around 30 - 70,000 words was ideal - in the end mine was over 80,000 but as it was quite technical in places and needed a lot of explanation I deemed that ok. There is an important payoff between length and cost so this is important.
2. Proof reading
   I got a friend who specialises in this to do the proof-reading - don't attempt to do it yourself as you will not notice errors. Even after this was done there were still some that escaped so I would say get it proof-read professionally and then maybe read by someone you trust to see if they understand it and it makes sense.They can also point out anything that they notice that may have been  missed.
3. Kindle version
   I then went on to the Kindle self-publishing website and found a template which enabled me to copy and paste into which made the kindle pages the right size (6" x 9")is industry standard and paginated accordingly. After that it was simple to check the layout and make any necessary changes using their tools.
4. Print version
   For the print version I knew I'd have to do a lot more work; I chose to use CreateSpace which is an amazon company dedicated to self-publishing print to order books. Now, some of you may grown but it has been invaluable in the help they give you and the easy interface with amazon, which, after all is the biggest bookseller in the world. I did some research on alternatives, which work out slightly cheaper per print copy but then you had to pay more up front print costs which, since I had no idea how many I'd want, seemed not a good idea. The point after all, is not to have to order loads of books that you then have to store. Print to order is exactly what it says. They're only printed when someone orders a book and then you get your royalty payments accordingly.
   
   This proved to be quite tricky and took almost as long as the proof-reading as the system has to be re-published too each time you make an alteration to the text. So make sure your manuscript is finalised before publishing to the online tool.
5. Images
   These proved very tricky indeed - getting royalty free images is vital so either your own or ones which are clearly marked as such. you may need to search for these online and check. Also size is an issue here as in order to print well, some of the images I'd used in my kindle edition were not good enough for the printed version as the resolution must be much higher for print than for the web. In the end where I couldn't find a better quality image I had to reduce the size of the images - and keep re--publishing an proofing til the online tool accepted my version (it has some inbuilt checks here).
6. Printing
   The issue of colour or black and white is crucial - I wanted a colour print but it turned out that the cost to make a profit would have meant the retail cost to the buyer would have to be around £25 - not likely to sell well for a first-time author no-one has heard of!! So I chose to go for a colour cover (using my own artwork and again their handy design tools) and a b/w interior. It's come out fine, very clear and although I would have preferred colour of course, it still makes sense as the greyscale is quite well-defined for some of the more complex diagrams that require you to map to a key.
   
   Anyhow when I had to judge what a good sale price would be and determined £5.99 for a Kindle version £7.99 for a 300 printed page book was ok (actally this is cheap but as an unknown author I didn't want to price myself out the market). Each author needs to make this choice for themselves. you will also need to judge whether you want to give Kindle unlimimted rights to the digital version which gives you more royalties but means you can't advertise it anywhere else e.g another bookseller or on your own website.  you can reassess this after 90 days and change your mind.

The gut brain - strangely true

The gut is not just the site of your digestion it is also a key part of your immune system and the site of a good deal of the information relayed to and from your brain. It has even been called the ‘second brain’ or ‘enteric brain’ as it contains 100 million neurons i.e. more neurons than the spinal cord or peripheral nervous system combined[i]. It is responsible in no small part for how you feel; your mental state, mood and health. For instance, 95% of the feel-good chemical serotonin in your body is found in your gut. This fact has been suggested as the reason why many mental diseases have correlates in the gut e.g. autism and depression often have gut symptoms associated with them.

Vitally, via the roughly 100 trillion bacteria that it contains[1], called the gut microbiome, it contains enough bacterial DNA to produce a vast array of the metabolic products (vitamins, neurotransmitters, enzymes, and signaling proteins called neuropeptides) that our body needs to function. It has been said the human being is simply a highly evolved, complex host for bacteria  In fact, evolution has shown us that bacteria have often been instrumental to the development of the organism, as they have developed in symbiosis with us[ii]. Babies born via Caesarian section often have poor gut function as they have not been properly inoculated with their mother’s gut flora via a vaginal birth[iii]. This may cause the children to have more allergies and health issues than children born normally, including mental health problems. Given the increasing use of C-section in hospitals, and the likelihood of deficiencies being passed on from  that child when she too has baby, this has health implications for us as a society not just as individuals.

The importance of the gut in general health is often ignored. Nutrition is mostly ignored when you engage with conventional medicine. How often has your doctor asked you about your diet when discussing your mental  – or even your physical - health[2]? Having a good balance of gut flora is vital – I am not looking at purely psychological factors here as I am only too aware that the balance of your gut microbes is crucial to your mental functioning. Your gut microbiome balance is vital to functioning. Unfortunately as your microbes get more out of balance, your digestion becomes poorer, you intake less vital nutrients and your gut gets further depleted and imbalanced. Opportunistic bacteria and resident yeasts begin to take hold. Symptoms are gas, bloating, itchy, flaky skin, cravings for sweet foods, and ‘foggy’ brain. You can see it is a cycle: poorer digestion – less nutrients and higher yeasts – poorer digestion.

Figure 1 Digestive tract and immunity

 

Let’s look at one example of how this works. The gut is one of the most important sites of  your immune system – the gut wall is, after all, a form of modified skin and as such is an entry point of pathological microbes (i.e. the unfriendly type!). Hence it’s not surprising that the most evolutionarily ancient immune function (called the ‘innate immune system’), is based here. It is the essential non-specific first-line defence to invasion controlled by the release of inflammatory molecules called cytokines. These are peptides (small proteins) produced in the body which control inflammation. Continuous stimulation by bacterial structural cell wall sugars called lipo-polysaccharides activate the immune system to be in a state of constant alert, helping to keep it activated. Bacteria keep us primed!

The release of cytokines is controlled by the balance of these polysaccharides and it helps the body maintain its immunity and, via their or its interaction with the stress response, even its normal sleep pattern (they are involved with the transition to Rapid Eye Movement sleep from non-REM sleep). This is important for dreaming and restful sleep. So, the balance of your gut flora influences your immunity and the quality of your sleep; therefore both directly and indirectly affecting your health using bi-products of their metabolism. This leads to the perhaps surprising conclusion that bacteria are essential to our physical wellbeing.

However, they also govern the balance in your mood and anxiety levels via the serotonin and other neurotransmitter levels they produce. Surprisingly most of the serotonin in your body is found in your gut. This is why when we increase levels via anti-depressants (the SSRIs like Prozac reduce re-uptake) you often get gut problems as a side-effect; oo much serotonin is just as much of a problem. So gut flora are vital for mental health too.

Another factor influenced by your gut bacteria is the permeability of your gut. With a standard western diet (also called the ‘standard American diet’  (SAD) in the US), your ‘bad’ bacteria are encouraged to overgrow which can cause the cells in your gut to become ‘leaky’ i.e. the gaps between the cells instead of having ‘tight junctions’ as normal, develop gaps. If you were unlucky enough to have childhood infections and were then prescribed extensive antibiotics these can affect gut flora for life too and exacerbate the problem. Antibiotics are non-selective about which bacteria they kill – the same is true of ‘anti-bacterial’ handwashes which are highly damaging to the gut.

Toxic bacterial overgrowth can encourage auto-immunity as undigested protein fragments (peptides) and toxins are able to penetrate through the gut wall causing the body to react with an immune response to food as if it were an invader. The cells in the gut are meant to be a semi-permeable barrier, finely controlled so as to only allow certain things in. When this control fails by the cells being permanently open, the barrier is broken and disease may result. Excessive permeability has been implicated in such definitive auto-immune conditions as diverse as coeliac disease, multiple sclerosis and chronic fatigue syndromes.

So, leaky gut syndrome is a precursor to many diseases as the gut is key in regulating so many bodily functions. In addition to the direct effects on immunity and inflammation, there are more factors in gut functioning that impinge on your health. The short-chain fatty acids (breakdown products of indigestible carbohydrate in your diet produced by your gut bacteria) are epigenetic regulators[3]; that is they help to control what genes are expressed in the cells. These epigenetic effects of the gut flora help to explain why each of us reacts differently to our environment – since each of us has an individual gut flora we have a unique response to the external environment. Those with a healthy gut not only have a healthier immune system but digestion and metabolism work better, with more nutrient availability, more accurate genetic regulation and intercellular communication. It can’t be overstated how important this is for brain function, especially in the area of pain response.

Although we are all familiar with the idea of ‘gut feelings as a source of information, we are seldom aware how vital the gut is in central nervous system (CNS) function. The enteric (gut) brain really does exist and it is just as important as the brain in your head. Stress (whether conscious and acute, or unconscious and chronic) alters the balance of your gut flora via the release of hormones like adrenaline and cortisol (from the adrenals) and cytokines produced by bacteria. The self-regulating system is sent haywire and the results are systemic (i.e. throughout your body). These findings are so important, the study of these interactions now has its own field

This is an extract from my book Stress, Trauma and Unresolved Emotion in Chronic Disease.

 

See here to purchase copies (digital or paperback)

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[1]10 times the amount of cells in your body! The combined gut flora has been called the ‘third brain’. Gut and brain start off as the same tissue embryologically. They then differentiate into central and enteric nervous systems. The enteric nerve cells are considered part of the autonomic nervous system in some newer definitions, see polyvagal theory later in the book. Brain, Gut, Microbes; First Second and Third brain.

[2] While writing this book I had a free GP health check organised by the NHS. The nurse did not physically assess me (apart from to weigh me and take a blood test). She asked a little about my diet and exercise but it was very general and no advice was given to reverse my hormone imbalance.. What an opportunity missed to educate people about health.

[3] ‘Above genetics’. It means there is another layer of control above what DNA you have. It is a very exciting development in biology. See the epigenetics section for more information.

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[i]Hadhazy, Adam.(2010). Think Twice: How the Gut's "Second Brain" Influences Mood and Well-Being. Scientific American. February 12

[ii] Yatsunenko, et al. (2012). Human gut microbiome viewed across age and geography. Nature, 48 6(7402), 222–227. doi:10.1038/nature11053

[iii]The Human Microbiome: considerations for pregnancy, birth and early mothering. January 2015 http://midwifethinking.com/2014/01/15

Bowlby's Attachment theory, trauma and scientific dogma

Was very honoured to attend a lecture yesterday organised by the Hampshire Association of Counselling and Psychotherapists (HACP) featuring Sir Richard Bowlby the son of the eminent psychiatrist and researcher who, together with Mary Ainsworth, developed attachment theory of human development. I cover the significance of this theory in my new book but it was great to hear it 'from the horses mouth' so to speak via his son. It's interesting that his theory was so radical at the time (and very contrary to the current understandings of human mind of his supervisor and senior colleagues) that he almost failed to pass his psychiatry exams! Until then it was though that any behavioural problems with children were due entirely to failings in the brain of that child rather than as a direct response to their environment (and specifically their bond with mother). It was a radical departure to suggest that the infant brain was affected in its development by the degree of attachment to the mother (and later the father).

Mary Ainsworth, (who, typically, is often missed out in the official record), developed a practical test called the 'Strange Situation' to monitor the behaviour of very young children (typically less than a year old) when a stranger enters the room, and later the mother leaves. They identified 2 distinct patterns (later expanded) - securely and insecurely attached. We watched videos of these experiments and close-ups of the children's faces which would search their mothers eyes for clues to whether this was safe or unsafe. Children who are securely attached (i.e. have bonded with their mother who is attuned to their needs) will seek close proximity and refuse to be comforted by a stranger. Those insecurely attached will dissociate (show by a wide eyed look of pain but numbing) and play disconsolately with their toys instead and show no relief when mother comes back. It is a telling moment because these bonds and their behavioural adaptations remain with us for life.

We can become avoidant of close relationships because we are not sure we will be rewarded/comforted or clingy where we feel imminent abandonment so ask for constant reassurance.
I was so interested to see the neurological consequences are being considered finally.

In the afternoon Richard presented the results of a pilot study conducted by another researcher Jane Sherwood who has proposed that early trauma across the generations of the maternal line may predispose to Alzheimer's Disease (AD) and dementia generally. It was fascinating stuff. She's written a book called  'In the shadow of Loss'. Richard was careful to say there were flaws in the study as it was small and privately funded but nevertheless with 120 participants and a clear pattern of association, not to be dismissed. Indeed I think we may be able to point to a  method of transmission. Mitochondrial DNA is passed from the maternal line and is intimately linked with the cell danger response when stress (environmental including attachment trauma) is present. This switches off the efficient energy production cycle of the mito's into a low energy pathway. We know that AD results in protein tangle accumulation in the brain but not everyone who has these gets the disease. Could it be that trauma is at the heart of this disease too.?

Richard was clearly in the shadow of his father but sensibly has decided to dedicate his life to further promulgating his ideas while not taking any money for doing so (remarkably his career has been designing racing cars!). So we were privileged to hear the latest research and without having a/ travel to London or b/ pay a fortune. Thank you Sir Richard and the HACP.

Human Givens

Read an article written by the Human Givens originators Ivan Tyrell and Joe Griffin on depression - was really interesting - I realised 3 of my human needs are not being met right now with the problems I've been having with my clinic not being watertight (= secure) despite being busy:

• Security - safe territory in the home (read home AND work here)
• Volition - a sense of autonomy and control over what is happening (I have no control whatsoever - unless it's over my response)
• Competence - a sense of achievement (although met in other ways i.e. professionally I feel really incompetent when it comes to looking after the building. I can't solve it and I spend all day and night worrying about it.

So, my sleep is permeated by awful dreams which leave me exhausted. Human Givens have a theory for this too which is that dreaming is a necessary discharge of the Autonomic Nervous System (ANS) in order to balance what has been denied during the day. Too much REM sleep and not enough slow wave which is responsible to restoring the immune system and cellular health. How interesting.. That explains why I wake exhausted and still 'wired' despite loads of dream sleep.

They have developed an 'expectation theory of dreaming; "dreams, as we shall see, is nature’s way of metaphorically discharging the autonomic nervous system (ANS)  of accumulated expectations we got worked up about during the day and did not deactivate by taking action in the real world. Emotions, we know are both motivators to DO something (from the verb emovare 'to move') and our greatest intuitive connection to our own truth. The problem is when they get stuck, as in depression, and we feel powerless to change them, our innate needs are not being met and the ANS gets set into fight, flight or freeze which sends us into a downward spiral of rumination and fear. This is the essence of depression and anxiety and it explains why it feels so physical; there are very few physiological processes that aren't affected by the ANS: immunity, metabolism and digestion being just some.

In some ways the Human Givens ideas are very much in parallel with my own that I detail in my book: Stress, Trauma and unresolved emotion in Chronic Disease. But my approach is probably more geared towards the body than this purely psychological framework would have it.

Great British Bake off - a multicultural phenomenon

Well we're nearing the final of this incredibly popular TV show.. how to explain it's popularity? Sure, it's a competition and the nerves are jangling as you watch the highs and lows of the various challenges. But, I think, more appealing, is the ability of 'ordinary' people (albeit superb bakers) to raise themselves and their art week after week with humour and emotional honesty. Of course, it's great TV, and edited no doubt to keep us hooked, but I for one think it's done more for tolerance and understanding of what it means to be an immigrant to this country (2 of the 3 remaining have families from other countries) including a British born Muslim woman who wears a headscarf and a 'hearthrob' man of Indian extraction.

Here's the phenomenon - we can identify with people as people regardless of race and see their common humanity - through the medium of cakes! Riveting stuff.

http://www.bbc.co.uk/news/entertainment-arts-34423035..

The scar that won't heal

Today is a very important day. It's the day after I uploaded my book to Kindle - a year's work and a very intense year it's been. Not only did it take a year's writing to get the 85K words, but then there's the proofing (thanks to the stalwart efforts of a friend), references and booklists to compile, getting someone to write the forward and so on. The book was actually written about 2 months ago but all the rest took a long time to complete.

During this time of writing and fretting, I've also been struggling with some personal issues which has entailed me getting quite anxious in a way that hasn't occurred since my last bout of depression 15 years ago. Initially all was going well but sometime around August my clinic (which is a conservatory at the back of my house) developed a leak. After heavy rain a stain would slowly make its way from the corner of the room and fill the air with the smell of damp plaster until it dried out again with the sun. Now, under normal conditions I would just call in the builder who erected it and demand reparations. But he is not to be found.. And I have no written guarantee despite months of requesting it. Beware a builder who can't/won't respond to your requests for things in writing!

So I called in another builder who has painstakingly worked backwards from the most likely cause to the least, repairing and making 'good' various badly done bits from flashing to the roof. After each repair comes the hope, then dashed after the next rainstorm. Finally this last weekend I admitted to myself my reaction has been so extreme, that I need therapy. I can't sleep when rain is due, my guts churn, my chest feels tight. I can't sit still, or eat for worry - and it feels like a personal attack when that stain comes back time after time..

So, of course it's no co-incidence then that my book is called The Scar the won't Heal; Stress Trauma and Unresolved Emotion in Chronic Disease'. Perhaps in the writing of it, I have touched upon some of my most painful memories, including the death of my father at 19. In EMDR (Eye movement desensitisation and reprocessing) therapy this week, it was this that came up. My feelings of abandonment when he died, and that I was somehow responsible. How strange! I know logically this isn't true but my emotional brain believes it, and the issue of fixing the leak has become a cipher for what I couldn't achieve 30 years ago. I had no control then and I have none now.  And both things seem to threaten my sense of self in a way that sounds ridiculous but nevertheless that's how my body is reading it.

So, it's really been a case of 'healer heal thyself' and I have tried to see this time as an important reminder of how illogical emotional memory formation is and how it affects us in later life if triggered. Which is exactly what my book is about - and how this can translate into anxiety, depression and chronic pain, IBS, TMJ, etc. So the universe has given me another swift kick up the backside to look at myself and deal with my stuff so I am in a better position to help others deal with theirs. Onwards people. Oh and please god I get the leak mended soon. Driving me crazy. Literally.

Highly Sensitive People and Business

As I've nearly finished reading the Highly Sensitive Person by Elaine Aron (and what  a great book it is!) I thought I'd put my thoughts down about how this relates to me (definitely an HSP) and those of us who are working as therapists, counsellors, health workers, etc. It seems to me that most of us are that category of easily over-aroused people who therefore prefer to be our own boss, having quiet time away from the hubbub, and avoiding the strident dominant types who tend to run corporations and, increasingly these days, public life (including service sector and local government, education, etc), According to Elaine, about 20% of people are born this way, and the only way they can survive and thrive is to create an environment that fits this personality style. Well, I seem to have done that.
Working with clients is a very introspective process, but as we need people it is also a chance to contribute and make a difference in life without the over-stimulation that high pressure sales, or self-promotion that entails.

However the downside to this I've found is  though we're very good at the therapy bit, we're less confident around marketing and promotion which we largely leave to others or completely. Hence there are a lot of us out there seeing maybe 3-10 clients a week, making do. If, like me you're also running a small therapy business then maybe you'll recognise the following scenario:
You know you're rubbish at the marketing. you want more clients but you hope they'll just come to you. You see an ad for 'how to market your therapy business/ conquer social media/ find your inner salesperson and you sign up. you do the study for a while, you apply a few of the ideas (which are usually sound) but, because they put you in the uncomfortable position of being 'out there' selling yourself, you soon lapse and fall back into your own routine. Another course wasted. And of course there is no shortage of courses...

It seems to me that there are lots of 'A-type' driven people out there selling courses for how to be more like them to those of us sensitives who know we can't do it. After my last course (about the 8th!) I vowed to do no more. It's not that I don't think it's a good idea to focus more on marketing myself. I just struggle because it's not 'me'. It feels all wrong. I try but it  comes over as inauthentic and that's how I am perceived. So, I've decided I'm not going to do it their way. I'm going to write a book, do my PhD and develop myself steadily, with focus but no rush. It saddens me to think there's so many of us therapists out there doing good work but most of us feel inadequate in some way cos were not out there selling our latest juicing package or social media marketing techniques. And yet, we do ok. Truth to tell, we don't want to be seeing 40 clients a week like the courses tell us we should be. We want to do what we do but not to overstimulate ourselves with sales targets and radio interviews and accolades. I say that knowing that there are some therapists out there who do and good luck to them. I see them making great headway, helping more people, that's great. But I have to accept who I am, not because I don't want to get better or improve my lot, but I don't want to do it their way. I want to do it mine. Slow but steady.

My Book nearly completed and musings on Virgina Woolf, Amy Winehouse and the nature of trauma.

As I near the completion of my soon-to-be-published book 'The scar that won't heal'; healing everyday trauma and unresolved emotion', I realise I have learnt to  notice the effects of trauma so well that I can spot it in the stories or lives of others. Yesterday watching the new BBC series 'Life in Squares' about the Bloomsbury Group, it suddenly occurred to me that the reason that the writer Virginia Woolf suffered from such debilitating depression was maybe due to a traumatic incident in childhood. Nothing in the series indicated that fact. It was purely from the evidence of her early struggles with mental illness, the triggering of severe relapses by the death of her parents (which I read about subsequently) and something about the strict Victorian upbringing which the series so clearly shows, which stultified the two women.

The Victorians were notorious for their sexually strict morals (outwardly) and the therefore unfortunate fact that many children were sexually abused in secret. What differs then of course was that no-one dare talk about it - Freud when he first declared that much of the neurosis he saw was due to sexual abuse of his clients as children scandalised Viennese society and he was forced to retract the idea and declare instead that these were children's fantasies (after all doesn't every child want to have sex with their parents??). Sadly these ideas were universally accepted as he was so influential no-one dared to disagree for many years. Even in the 1970's a standard psychiatric textbook declared incest to be so rare as to be unimportant and in any case had no significant effect on the child!* Today after the Jimmy Saville enquiry and the grooming of children in major UK cities we know differently..

Children are profoundly affected by such experiences, as well as lesser traumas such as being unloved or betrayed and the result, when their brains are still forming, is permanent dysfunction from subconsciously triggered traumatic memory. And, as my book makes clear this has very real physical results; dizziness (fainting), tinnitus, depression, migraines, panic attacks, irritable bowel syndrome and so on. These effects are real and they could be the basis of much mental and physical suffering including bipolar disorder which Virginia is believed to have suffered from.

I was incredibly saddened but also vindicated to read that she and her sister Vanessa, had indeed been abused by their half brothers, George and Gerald Duckworth, as she recalled in an essay ' A sketch of the Past' written in 1939. Could our current understanding of traumatic memory have saved her if she lived today?

Would Amy Winehouse be dead if she'd had trauma treatment rather than standard addiction detox therapy (the eponymous 'rehab' of her famous song). This relies on abstinence which deals with the effects of addiction but not the cause. As soon as the stress builds up again, the cravings return. Although she did not have abuse in her past, she most definitely had trauma - the divorce of her parents when she was 9, was, to a highly sensitive child, hugely significant. And then, in later life,  her father wasn't able to provide the boundaries she so needed. Add to that meeting a similar addictive, traumatised partner, and her death was assured. Trauma is no respecter of talent.

But would she and all the other people who have these hidden scars be healed now?  To be honest it's unclear whether this information has filtered down to mental health professionals, or certainly primary care where most people first report mental health issues. There is still much work to be done. I hope in writing my book, which details much of the science behind the stress response and how it relates to traumatic memory, will help elucidate this information to a sceptical public and other professionals. The science is there. It just hasn't been joined up sufficiently yet to be understandable within a specialised, fragmented medical model. I hope to redress that balance.

* Bessel van der Kolk, one of the worlds' leading figures in the study of trauma, read us an extract from the manual as part of my trauma training. It was mind-blowing.

Why whole grains may not be good for you after all

The problem with Grains

For many years I have believed that whole grains were part of a healthy diet and have swapped my processed cereal breakfast for an oat-based one I made myself with nuts and seeds that I added.. however I note my teeth are not in great health (and where the teeth are going the bones soon follow). I have had to have a root canal filling and the enamel is chipping. Recently I read an article that explained the problem.
Certain whole grains (especially oatmeal) contain a molecule called phytate that inhibits mineral uptake - it binds Phosphorous in a form that we then cannot use, Calcium which we need for healthy bones is then leached from the body and we get bone loss - unless we have enough Vitamin D and other fat -soluble vitamins.
High-phytate diets result in other mineral deficiencies too; Zinc, Magnesium and Iron are all inhibited. This would explain why my iron levels are low even though I eat a wholefoods diet.

Solutions

So what can we do? Well firstly we need to soak or sprout the grains first and if you are not prepared to do this then you need to swap a grain-based breakfast to one based on animal fats like egg and butter - it is interesting that absorbable calcium from bone broths and raw dairy products, and vitamin D from certain animal fats, can reduce the adverse effects of phytic acid. Get yourself a slow cooker to make your meals with meat on the bone..
Add Vitamin C to your diet to help iron absorption. Research shows that adding ascorbic acid significantly counteracted the effect s of phytic acid in wheat. Green leafy vegetable are best but of course if your gut is compromised you may have difficulty absorbing them. Once cooked they tend to lose most of their vitamin and mineral content so the best thing to do is to juice raw greens.. Adding Vitamin A and beta -carotene from coloured veg is also good - so add beets and/or carrots to your juice/blend..

Why now?

Why are we only now having this problem? Well it seems that humans do not produce enough phytase to safely consume large quantities of high-phytate foods on a regular basis because our gut flora are compromised (due to toxicity, spraying of foods, poor diets etc). We need them to produce the enzyme that digests phytates; phytase which makes the phosphorus available and reduces the mineral depleting qualities of the molecule.. One species of good bacteria in particular seems to help more than others; probiotic lactobacilli and other species of the endogenous digestive microflora can produce phytase. Thus, humans who have good intestinal flora will have an easier time with foods containing phytic acid. Increased production of phytase by the gut microflora explains why some volunteers can adjust to a high-phytate diet. Sprouting activates phytase, thus reducing phytic acid.
 
We need to sprout and soak our grains and eat more animal fats! Almost opposite to the advice we have been given for years. So eat your butter and yoghurt (which is semi-fermented making the milk less allergy inducing). If you eat meat, cook it slowly it on the bone and not frying in polyunsaturated oils - (vegetable oils). Use coconut oil, or olive oil. And, juice all you can.

For more information see http://www.westonaprice.org/health-topics/living-with-phytic-acid/
 

Mental health in the news

2 main stories in the news this morning highlight the huge differences in the way mental health is treated compared to physical health in the Western Medical model.
The first concerns the German co-pilot Andreas Lubitz who deliberately crashed a plane with 150 people on board. He apparently saw over 40 doctors in the two years leading to the crash, with clearly no-one able to help him. It is a sad testament to medicine that we fail someone who so clearly was crying out for help. We may have saved so many lives if he had been...

The second story is about how the NHS treats  mental health with the story that  A&E staff are failing to treat and condemning people who harm themselves. I can understand this as in the past I would have been the same. But after training in trauma therapy extensively I now recognise the drivers of cutting and self-harming acts - and why people are driven to do them. They are calming for people whose nervous systems are so geared to threat that cutting actually down-regulates (reduces) that threat by changing the hormone system balance. Most 'normal' people find that hard to understand (though we regularly engage in similar but less violent acts of numbing like shopping, drinking, TV watching, perfectionism and over-work). It just seems that our ignorance is costing lives as when the people who should know about this i.e professional health care workers, do not and treat people as time-wasters and malingerers.
http://www.theguardian.com/society/2015/jun/12/ae-staff-attitudes-to-patients-in-mental-health-crisis-often-shocking

Mental health is woefully underfunded and ignored. Where provision is provided it is patchy and far too often relies on inadequate pseudo-diagnostic criteria like ADHD and now a whole raft of new disorders based on certain displayed character traits (see the latest psychiatrists' manual the DSM-V for the full horror of these unproven, poorly researched 'diseases'). These categories tell us nothing about what is going on for the person with these symptoms - they are based on a system that rewards a diagnosis with insurance payout. They have nothing to do with what is really behind themMost of the problems we see in Western society are a result of spiritual disconnection, nutritional depletion and a poor understanding of how memory and trauma are encoded and treated.

As I meet more and more ordinary people who exhibit signs of mental distress - and these are the functioning ones, I begin to see this is the tip of the iceberg. We are so far from living health, joyful lives and our culture encourages disconnection via envy, money grabbing, celebrity culture, etc. We need to recognise we all need love and connection, and that includes self-love as well as that from others. We need to be recognised above all, for who we are as individuals and have loving, supporting relationships. This cannot be prescribed unfortunately, but when someone falls out of their ability to cope as many do, they need a caring and understanding health service that offers more than crisis support. The model of trauma resolution that I use allows people to recognise that their symptoms are a desperate attempt by the mindbody to keep them safe, even though it has become untenable in their adult lives it needs to be acknowledges where they have been, and how strong they are to have survived. We need to promote understanding of the inherent goodness and healing ability of people, not treat them as abhorrent weaklings whose problems need to be dismissed, medicated and covered up. There are answers out there, there are amazing new treatments not yet available on the NHS but they all require a totally new approach to health and healing which is self-acknowledging and driven. I look forward to the day when suffering such as this is a thing of the past.

Why is nutrition considered 'alternative medicine'?

Watched the first of this BBC series last night on I-player.

It looks at the range of private medicine on offer in Harley Street. It was interesting watching the doctors justifying working privately (some of them worked in the NHS and all of them were trained there). I have no problem with private medicine per se - it's that the standards are so much higher but it's not available for all. The same problem with private education of course.

My main issue though was with the fact that despite mentioning the large numbers of alternative practitioners who work in Harley street the programme failed to highlight any of them and instead focussed on the same narrow 'conventional' medical treatment plans including a lot of high tech chemotherapy and surgical interventions. And all were male interestingly.

It's the same old same old as far as I'm concerned.. no mention of what any of these people could do to help their treatment with lifestyle and diet changes, no mention of stress or inflammation as contributors to the conditions shown.  All seemed to believe in the magic bullet approach. One woman, who had underdone chemo and a lumpectomy was told 'that's all the cancer out of your body - you are now cancer-free!' Which of course was very emotional for her as she'd gone through months of hell with losing her hair and all the worry and fear of cancer. It seems churlish to point out that there is always cancer in your body, but a healthy immune system keeps it in check. There was no attempt to give her any advice on nutritional changes she could make to make sure it stayed that way. And her family's response was quite dysfunctional - as a student psychologist  I looked on in incredulity as they seemed to depend on her to stay well, clinging on to the notion of her survival like it was their life that was at stake. There's a story in that family of previous trauma for sure..

One lad came from Kuwait to be told he had a pituitary tumour that was threatening to take away his sight. No comment on the fact he was obese and needed to look at the role of excess weight in causing cancer. Surgery was the only thing on offer.

It was all so depressing.. I DO have a lot of respect for the skill of the surgeons and the wonderful technology that we now have at our disposal (if we have the money it seems). Also,  I understand people want to have their pain taken away. But our approach now in the west is so disempowering of the individual. It takes away everything that we can do to help ourselves. And it makes vast profits for the biomedical industry it supports.

Why oh why is something as basic as nutrition considered alternative? It makes no sense to me.
Just yesterday I was advising a client on dietary changes she can make to help her acid reflux. Very common in women, particularly over the age of 50 as the hydrochloric acid in your stomach decreases which opens up the valve to the oesophagus causing reflux, amongst other things. The problem usually isn't too much acid as you will be told by the doctor. It's the opposite. I recommend this article to read on the subject by the reliably good and evidence-based Doctor Mercola. So, you end up being prescribed drugs that reduce your HCl further and... hey presto.. it get's worse.. It beggars belief really. Anyhow if any of you out there in bloggerville are interested then please see my links and my website (and social media links). I try to keep it positive, but sometimes.. Grrrrr...
There I've finished now.

Perpetual student of wellbeing

Well I said 2014 would be the year of consolidation in my life: i.e.I would do no more courses for a while and concentrate on building my business. This has happened but  I must be honest and say I haven't given up studying completely. I have been doing a trauma treatment course by Dr Janina Fisher which looks at various models of trauma and how to overcome it. It's monthly by webinar and has been very instructive as the other students seem to be mostly psychologists and have a particular language and terminology that I don't always follow (not having studied psychology formally at university). But I have begun to pick up some useful tips about operating within the 'window of tolerance' with neither hyper or hypoarousal and thus being able to function well in the world which is the goal of every person but sometimes goes awry in children subject to relational (and other) trauma

 

I am also looking at Shame and Vulnerability by doing a self-study course with my favourite shame researcher (are there others??) Brene Brown. She runs a video based course here I am, as you see, a perpetual student.

 

But finally 2015 has come around and I wish to increase my credibility with my clients by obtaining a PhD. This isn't an easy task as you might guess as the area I am working in is not that common and my approach is not strictly psychological or medical. I am instead in the 'no-man's land' of being in a holistic field which rigidly defends its position as being research-based and yet if the research does no fit the current paradigm it is not accepted. So, I am having to go a bit 'off-piste' and do my research privately via a PhD registered in India. my study is going to be looking a the common trauma of everyday childhood experiences which, in some sensitive children, causes them to develop symptoms akin to PTSD. We don't have a name for this yet although common PTSD has been mooted by psychiatrists. I believe I am a someone who has this in my history, and it would explain a lot about my reactions to events in my life and my physical symptoms of Chronic Fatigue and depression. I would like to investigate this link by creating a questionnaire to be given to volunteers who suffer from  any of the CFS style conditions including any sort of Chronic Pain (which has lasted for more than 3 months). I am developing the questionnaire at the moment. I am hoping to be ready to send this out to groups and individual by the end of May. I have set up a page on my website devoted to it to give potential respondents more information, If you know anyone who might be interested in taking part in the study please direct them to this page for more information.

So, at the end of the study I should have more information on what the common factors in the personal history of sufferers is. I will keep you updated as I develop this further.

Dissociation as a response to trauma

Whether one has suffered the trauma of abuse or the more cumulative low key trauma of rejection or poor parental attachment, dissociation is often the result. If the dissociation is very severe it may interfere with the person being able to inhabit their body and 'depersonalistion' is the term used. Whatever the diagnosis (and there are many in the latest psychiatrists' diagnostic manual the DSM-V), I aim to look at it as a survival technique rather than an illness. In therapy I am keen to help clients understand it as a clever way that the mind has devised of keeping them safe. This approach rather than being locked into inhabiting your diagnosis (I am dissociated, I have dissociative identity disorder DID) has the benefit of empowering the person rather than allowing them the sink into passivity..

People with this condition may well have always struggled with being social in larger groups and found that they retreated into their own quiet world to survive. Of course social anxiety is common, even among those of us who consider ourselves mentally well it is quite a stressful thing - it's just that most of us are clever at hiding it! For trauma sufferers it is completely intolerable. They cannot even work up the courage to walk into a room where there are large numbers of people...

The sad things is that with this degree of dissociation, the sufferer does not feel real in their body, and their interactions with others are superficial. One client told me the only reason she could come and see me is that I look like a 'cardboard cut-out' to her so she doesn't really believe I'm real either. I felt inclined to show her I have three dimensions and am as real as the chair she is sitting on but she doesn't believe that is real either so you can see that the perception of reality is altered and makes functioning extremely difficult.

However, it is important to feed back to these clients that the problem is in their perception, not the reality.. the reality is that their body still notices everything that happens to them, and responds to it. But they are simply not aware, the disconnection is between the sensation (and the feelings that these engender - usually fear) and the interpretation by the brain (meaning - e.g I am in danger). I always stress that the disconnection they feel is ultimately a safety valve for the feelings that have simply become intolerable. Particularly when the feelings are ones of rejection and humiliation (shame) from those who are meant to love you, those feelings are simply unacceptable and are disconnected from the mindbody completely.

So, when you understand the dissociation as a symptom of your experience (usually sensitised early in childhood to rejection and shame) and how then you have interpreted things, the labels no longer matter so much. They are just defences your mindbody has erected. They can be dismantled but very, very gently. This degree of spiritual disconnection from your own body cannot be solved easily.

The usual approaches to trauma, like EFT and EMDR are difficult to apply as the person is asked to concentrate on their feelings as a precursor to both techniques which is almost impossible for them. So, although I do use these, I have to allow the person to gain confidence in trusting their own body not to betray them first by

• psychoeducation
• bodywork
• pendulation

One of the techqniques I have found especially useful in the beginning is applied kinesiology - it has a huge following in chiropractic circles where it is used as a sort of communication system with your subconscious. I find that very interesting but, more appropriate for dissociation disorders is learning to use it psychologically. Check out these two videos; in order they are Bruce Lipton;

and Rob Williams.. They are a 2-lecture series on 'The biology and psychology of perception'. I hope you find they inspire you as they did me. Both men are respected in their individual fields, Bruce in particular is a cell biologist so nothing flaky there.. his book The Biology of Belief is required reading for anyone interested in the mindbody link.

Finally, its worth noting the more naturopathic interpretation of this is that you have a deficiency of spleen energy - apparently there is a link between the spleen and rejection. See

It may be a little too 'woo-woo' for some who reject the notion of meridians, but its written by Alison Adams who is a highly qualified UK dentist and now naturopath. Her website is full of nuggets of information. I am constantly amazed by how many conventionally trained doctors and other clinicians are finding truth and answers in the more esoteric fields of 'alternative' health.

The ups and the downs of ageing and selfhood

Having had a strange few days of highs and lows I have been pondering the nature of ageing and what it means to inhabit our bodies. My mother had some sort of heart arrhythmia a couple of weeks ago and has had a pacemaker fitted. I went to visit her for the first time yesterday (having not been well enough really to visit at the risk of passing on whatever flu bug I had).  My mum is 81 and has previously been a healthy and active person, working one day a week in the local PDSA charity shop and visiting my brother every Saturday on the bus. I fear that may have come to an end.

She collapsed while having her hair done at the hairdressers, she doesn't remember passing out, she only knows she woke up in an ambulance. She was out for approximately 10 mins and they were worried they wouldn't be able to rouse her. She was then taken to hospital for assessment and endured what sounds like a typical A&E experience in this country, where she was left hooked up to a ECG machine on a trolley for 8 hours while they waited for a bed. She says all she had with her was her handbag and they had put her in a gown but not given her a blanket or drink until she begged the nurses saying how cold and thirsty she was. She says they looked annoyed when she asked (which mirrors my experience - they are all under such tremendous pressure with not enough staff that the basic kindnesses go out the window).

She had her pacemaker fitted the next day in what seems like a miracle procedure - local anaesthetic and inserted through the artery under her arm. She was discharged after 2 days and now has care from 2 lovely ladies who come morning and evening to help her dress. She seemed well enough when I saw her but she shows signs of having lost a lot of weight, she has lost the use of her left arm (which is her dominant hand) so is severely restricted in cooking and dressing. I was a little surprised by how quickly she has become 'old' and passive. She is scared of using the microwave in case it interferes with the device; the booklet she was given says she is not to get within 6 inches of microwaves or hairdryers so, my Mum being ever cautious, she goes out the room completely when the microwave is on and hasn't washed or dried her hair yet, preferring to use dry shampoo. She seems convinced that she can't use her arm, even though the advice was just to not to lift it above her head for a few weeks.

Nothing I say can convince her, she waits for the consultant appointment this week to tell her whether she can have her hair washed, risk walking, etc. Women of my mother's generation (and class I guess) are in awe of their doctors and their word is God. Anyway it was a mixture of relief (that she has survived with her humour intact) and exasperation that I attempted to help and be a good daughter. I did her hair for her. It was a strange but oddly healing experience. We've never had the greatest relationship but I am slowly building it, as she ages and I find more compassion in my heart for her strengths (famously dotty, genial and good natured) and try hard to ignore her weaknesses (lack of empathy for those closest to her, judgemental at times).

And in that reflection of course is the fact that, as I approach 51 (this week!!), I feel, well, surprisingly young in comparison! I had gone to visit feeling quite down about my approaching birthday but seeing her passivity and helplessness, I realise I am not there yet and still have a lot of living to do. We are all ageing and we are quite terrified if we're honest but as I continue to work with my clients and learn so much through the work we do together I realise that our fears are universal and very, very human.

I had a dispiriting Saturday exhibiting at a Wellbeing day where I sat, ignored for the most part, as people who read cards or palms, sold crystals or even, gasp, make-up were well attended. Working on your emotional health just isn't that high up the agenda for most people. They'd much rather have a foot-rub! Can't say I don't understand that but I kept feeling that wellness is so one-dimensional if all it means is attending to the physical needs of the body.. I mean I love massage, (and I do it for goodness sake) so I'm not denying the importance but I SO believe in this stuff that I do and I get such great results when people are able to release their subconscious fears and beliefs that I can't understand why everyone doesn't get this excited. :)

I did have one 'client' on the day - she was another therapist who was interested in trying a taster session of EFT as she'd heard of it but she couldn't think what we could work on as she'd 'sorted everything previously with other therapies'. I asked her 'is there anything troubling you?'. She said 'well only this nagging back pain' so we decided to work on that. Now, I use Faster EFT with a few extra touches of my own from my training in trauma and hypnotherapy, and it's quite a quick and incisive tool. In fact within minutes I had my poor lady in tears as she reconciled the fact of not loving or forgiving herself for stuff that happened to her in childhood. I had not expected to go so deep so quickly but then I am not in control of what comes up. All I can do is take the person into their own resourcefulness to counteract the pain and move them in and out of that experience very gently - what we call 'pendulation'.  I hold the space and trust that their brain/mind will allow them to move through it. A feeling of safety is paramount and must be created beforehand.

I watched her face all the way throughout - the facial muscles and expressions are intimately connected with our emotions - via the vagal nerve - and are very instructive. Her face suddenly looked very scared and childlike. as we worked through what had come up and gradually defused the emotional charge, the adult began to creep back in. At the end of what had been perhaps 20 mins she asked me what I saw and I told her. She said it was very odd because that day she had grabbed a crystal to take with her (I don't know much about them myself but she was obviously convinced that their energy helps her); the one she had grabbed was for 'the inner child' apparently.

As we drew to a close and I asked her how she felt she said 'my back pain is gone' and looked astonished. This is no longer a surprise to me as it used to be. I now know that emotional stuckness can be expressed in bodily pain and it seems clear from the work I've done that the pain will often shift, or move or change its character in response to clearance of these old emotional memories. She walked away feeling and looking quite different. I don't know if she'll venture to come back and see me for a longer session - I can't control that but I know I did good work with her and I felt that my purpose for going that day had been realised. I then wondered as I looked at the young women handing out free lipstick whether they could say the same.

Book writing news

Started my book-writing course  (today) and although the title isn't fixed yet (something to do with Healing past trauma; how unresolved emotions undermine your health).. I've written some chapter headings and nearly 10,000 words. Of course since the first part of the book is my story (illustrating how even a 'normal' childhood can impact the adult experience of life), it's been reasonably easy to write (who can't write about themselves!). The next few chapters will use case studies to detail the myriad ways in which blocked emotions or trauma (even mild events can be traumatic to a sensitised person) can cause many chronic illnesses such as chronic fatigue, anxiety, and numbing. Finally I'll be looking at ways in which you can release these to live a more healthy, satisfying life.

Writing is always self-exposing but particularly when you are writing about your own experience and it has caused me some trepidation as many of the people I am writing about are still alive (my mother for instance). However, it's not a blame-game'. I'm very careful not to get into that with either my clients or myself. The point is; your experience is your experience - it's no-one's fault and the point of healing it is not to divert responsibility to someone else i.e 'it's their fault I ended up this way'. This is, instead, an honest account of how childhood events impact upon the adult by virtue of imprinting in the emotional brain (limbic system and brainstem). I think it's a fascinating area and explains why so many people have intractable pain and distress which does not respond to talk therapies (the origin of these emotions are pre-verbal memories which don't have a narrative).  For instance when I had my tonsils out at age 7 or 8, the idea then was that parents did not stay with you overnight. They just left you there. The experience was extremely frightening for me as my parents in their wisdom didn't tell me till the day they dropped me off, AND, it was the first time I had ever been away from home without them. Hospitals have never been my favourite places (I get a weird anxious feeling in them) and now I know why.

I am boosted in my understanding by a new book hot off the press by Bessel Van der Kolk; 'The Body Keeps the Score'. What a great title. Honestly, it's almost the book I wanted to write although based on his clinical experience which is far greater than mine (he is a trauma specialist in NY). I can't recommend it highly enough if you are interested in this field as I am. it was released in 2014 so bang up to date.

Anyhow, the writing process is ongoing, the main thing is how to publish and in what format - digital or print? lots to learn so an exciting time. Of course I'm not sure anyone will want to read it, but hey, I am determine to be positive. You don't know til you try. Happy 2015 everyone.