Roots to Thrive Founder

Written by Dr. Crosbie Watler

The question is, “which self are we coming to know?”  The DOing or the BEing?  Awareness of this duality of self is the most important awareness.  Bar none.

The BEing self is our essential quality.  It was there at our birth:  The Silent Witness.  Presence…awareness consciousness…simply, “I AM.”  No condition.  Before we lost connection with source and learned to tell a story about who we are.  Stories and judgements of ourselves, others and of the world around us.  And the stories are rarely good.

The DOing self is like shifting sand.  The roles, relationships, achievements, failures, appearance, possessions…and on and on.  The doing self is the weather of your life.

If everything is going perfectly at that level, enjoy it.  It won’t last for long.  Identifying with the DOing self is the primary source of suffering.  Like outsourcing our well BEing to the weather.

We were born steeped in awareness of BEing, before we lost ourselves to the monkey mind: “I think, therefore, I am.”Before we drank the Kool Aid and succumbed to the cult of disconnected materialism.

As we “grow up,” we begin to see ourselves as split off from others and from the world around us.  The illusion of separation.  Maya—the illusion of the senses.  Our culture reinforces this illusion of disconnection. Disconnect from source.  BEing.

It is always the perfect time to come back home to rediscover our essential nature.  BEing.  Grounding in witnessing awareness, without thought, judgment, or story.  It is our birthright and our highest calling.

THIS is the healing field of the the psychedelic medicines.  With the mind off line, we sit in front of the mirror, where we cannot lie to ourselves anymore about who we are.  Credit to Duncan Grady, a Blackfoot elder, for that pearl.

Outside of these medicine-assisted shifts in awareness, we can learn to step out of thought with intention—as in meditation. In the space between our thoughts, we experience the stillness of being.  Well being.  It reminds us who we are.

There is a crack, a crack in everything.  That’s how the light gets in—Leonard Cohen.  Our authentic self resides in the crack, the space between our thoughts.  That’s how the light gets in.

Whether we succeed or fail at any enterprise, the BEing self remains the dispassionate, silent witness.  The liberating transition to detachment:  I don’t mind what happens.  Non attachment.

When you are in that place and I’m in that place, we are one.  An  individual wave, aware of the connection with the ocean.

Be the change.

Written by Dr. Crosbie Watler. A true story by an inspired man.

The wee hours.  Wide awake with no distractions.  No escape in restful slumber.  Free and clear space.  I can feel the energy in my body.  It’s stuck and I’ve been carrying it all day, maybe longer.  I sense some of it is not mine—passed down.  My body wants to tell me something.  I can stuff it, numb it, or tell myself a story about it.  Been there, done that, time to shut up and listen. 

It started early this morning after doing an urgent video psychiatry consult.  Another story of a broken spirit, filled with fear and all stuffed in the body.  I felt that in my heart, like a weighted blanket.  All through the interview and with each breath, I held an awareness of space around my heart.  Allowing me to hear the story, to empathize, but not have it stick to me.   In my work, I strive to listen and respond from clear space.  The wisdom and intuition of the felt sense.  The signal comes through the ears, but the body must feel into the meaning and context.

This is the flow state of the interview…and everything else.  I wonder how many practice it, or are even aware of it?  We are in flow when we interact with the world around us from a place of self awareness.  Authentic self—the silent witness.  Shifting attention briefly to inner space, the pause between the in breath and the out breath.  Listen from there and speak from there. This brings the being to the doing, creating a healing field that is unseen, but felt.

Park the mind and use it only when necessary.  Thinking is highly overrated.  Intellect is there, but not much wisdom.  Wisdom and intuition reside in the gut brain.  The silent brain.  Ultimate truth—trust your gut, listen to your gut.  It will not speak to you, but you feel into the right choice, what to do and what to say.  You will learn to trust it.  It won’t lie to you and what flows from you will be righteous.  Sometimes it will surprise you.  You might sense that some of what you’re saying isn’t yours as it flows out effortlessly.  At those moments of peak experience, one becomes a channel.  Park the mind and allow it to flow through. 

All was smooth sailing until the patient transitioned to describing his frustration with our system of mental health “care.”   He detailed the medicalizing of his despair, with a series of treatments doomed to fail, as if by design.  I felt his creeping sense of desperation and helplessness.  That hit me in the gut.  I managed to keep a lid on things and completed the interview with a plan that gave him hope.  Then I signed off. 

That’s when I lost it.

What I lost was awareness of inner space.  The domain of the dispassionate witness.  I was no longer self aware, but in reactivity mode.  All the wisdom and intuition?  Summarily tossed under the bus.  The maestro has become a puppet.          

I don’t do freeze or flight.  I scorch earth.  I now know much of it is not mine.  I’ve lead a privileged life, mirrored and supported as a child.  Blessed with the love of a good woman, authentic relationships and a sense of purpose.  We think we know ourselves, but we are influenced by  unseen forces outside our usual states of awareness.  So much of what we carry is handed down to us.  The epigenetics of our ancestral experience.  Given our collective history, much of this is trauma.  In states of deep meditation—or otherwise altered states of consciousness—we feel our ancestors knocking.  Mine are part slave warrior and it explains everything.

I know in my bones that my ancestors were fierce.  They had to be, or perish.  Many did.  And here I am.  Last man standing.  They hand me the torch and ask, “What are you going to do with it?”  This uncomfortable gift of an easy life does not sit well with me.  I will make it hard.  I need the struggle.  Now I know why.  My ancestors have been pushing boulders uphill forever, in the face of impossible odds.  And here I am.  Last man standing.  Righteous struggle is in my DNA.  I seek it out in ways that leave many—me at times—gobsmacked.  In truth, I sense some of my ancestors might not have been so righteous, but I’m selective about whose torch I choose to carry.

All of this at 8:15 on a Saturday morning in the present day…at the mercy of unseen influences and swirling emotions.  On seeing the harm that comes from the medicalizing of psychiatry, the heaviness in my heart had given way to rage in my gut.  Yet another victim of the medical-pharmaceutical complex.  Patients have become commodities—their distress labelled as disease, or worse, disorder.  Failed medical treatments for wounds of the heart.  And it pisses me off.  Slave warrior gene is on.  Like right now. 

Can I please have something to vanquish?  A wild beast threatening my family, perhaps? Or enemy warriors sneaking into the village.  How about a serving of slave owner for dessert?  No such luck.  It’s 2021 and I’m living a life of privilege in the tranquility of Maple Bay, British Columbia.  I feel paralyzed by the heaviness in my heart and the rage in my belly—swirling, building, with no clear outlet.  That’s when it get’s messy.  Listening from space?  Yeah, right.

I should have done the work sooner.  It’s 3:30 on Sunday morning.  The karmic debt of procrastination.  There is no free lunch.  Do the work, or pay the price.  What the mind won’t acknowledge, the body knows.  You can stuff it for a while—maybe the righteous rage felt good.  It’s in my bloodline and it had purpose.  It was adaptive, but it no longer serves me.  It depletes me and everyone around me.  That awareness is enough.  There was no space for it earlier in the day, or maybe I did not want to make space. 

Making space is hard sometimes.  Keeping the monkey mind at bay is hard work.  I do it all day at my day job and sometimes I just want to let my guard down, to rest.  That’s when it sneaks up on me, the alpha predator.  The present day enemy is no person or beast, it’s the conditioned mind and its unconscious patterns of reactivity.  This stuff will consume you from the inside out, play you like a fiddle and dance on your grave.

So, here I sit in spacious awareness.  The wee hours when quiet contemplation is best.  It’s easier now—nothing to do, nowhere to go, just be. Presence, awareness, silence within and without.  Space within and without.  Where everything that was stuck in my body is washed away.  The radiant light of presence has cleared the skeletons out of the closet.  Presence slays dragons.  It is our super power.

Cultivate the healing field of presence, knowing you will lose it.  When you lose it, have compassion for yourself.  There are so many seen and unseen influences wanting to play you like a puppet.  In truth, presence can never be truly lost.  Presence is our birthright.  Sometimes we just get distracted.

Given these times, navigating chaos is now more important than ever…

Like the rest of the natural world, embodied BEing as opposed to disembodied DOing requires a delicate balance of chaos and order.  When BEing authentic, we lack self-consciousness (the insecurity that fuels incongruent displays), enabling inspired doing to flow from abundance.  We know we are in this abundant BEing state when the reward overshadows the effort.  Many refer to this BEing state as natural flow. This is us as human BEings. 

Relating to resiliency, with deeper personal roots, we feel secure, trusting that our environmental and relational contexts are adequate to navigate passing challenges.  Because we are securely planted, we have a strong sense of place in the world.  We interweave with others, giving in times of abundance and receiving in times of need. We have an abundance of fruits and foliage to navigate the external conditions and more than enough to happily contribute to those with fewer resources.  

Too much order happens when we predominantly act out of the left side of the brain.  From here, we fall into frustrated perfectionism, losing our power to a set of idealistic rules that we feel beholden to.  From this state of disconnected attachment to external conditions, we fixate on DOing. When we prioritize the opinions of others over our needs and values, we lack creativity, adaptability, and heartfelt meaning.  As a result of this growing incongruence, we carry shame, causing a chronic form of stress that fuels ‘freezing’ and ‘fleeing.’ From this place of fear and scarcity growth is limited, and we become prone to stagnation. 

Too much chaos happens when we predominantly act out of the right side of the brain.  From here, we lose control as we frantically and fearfully move from one moment to the next, lost in a state of unconscious reacting to the fires of the moment.  The space we need to drop into the inner world to stay grounded is chewed up by a barrage of distracting external stimuli.  When in extreme chaos, we lose the felt sense of our grounding and security in the world, causing the nervous system to divert our energy to ‘fight’ for our life.  From this place of fear and scarcity, growth is very limited (if not impossible), and we become prone to emotional and nervous system breakdown. 

Living in complexity, a natural state of flow, happens when we find our unique balance of order and chaos.  BEing human requires a certain degree of security in one’s inner and outer resources, which enables us to trust in the various interacting parts of life, all synchronizing in an ordered fashion.  It requires a trust in the natural order that unfolds when we act congruently in the world.  We develop this trust by practicing authentic self-expression in relationships that can provide compassionate witnessing (unconditional positive regard).  In this state of complexity, how we feel and what is important to us manifests in the world through this authentic expression.  Because we are not self-conscious or tending to incongruent display we think others need from us, our days roll by relatively effortlessly, fuelled with heartfelt meaning and connection.  From this place of abundance, growth is maximized as we naturally synchronize with our environment.

Depending on our nature and the nervous system’s window of tolerance for uncertainty, preferences will vary.  Some prefer living on the edge of chaos, leaning into the inspiration that flows from this freer way of being.  Others prefer living with more order, finding pleasure in consistent routines that provide frequent grounding opportunities and clearer direction.  We find our place on the order-chaos spectrum by paying attention to the expansion and contractions of the body.  When we are out of balance, the body gets activated, which acts as our internal alert system.    This is our cue!  When alerted, we have an opportunity to get curious.  When we engage curiosity, we become an objective observer because the very thing we are observer is now a distinct ‘other.’ With this space between the observer and the felt sense, the intense threat lessens, enabling the root emotion to be felt and tended to.  

One felt moment at a time, one compassionate act at a time, we find our way back to balance. 

“If you don’t like something, change it. If you can’t change it, change your attitude” (Maya Angelou). 

When we operate with a higher sense of coherence we are feeling into our agency (confidence in who we are and what we have), making us more able to optimistically re-orient ourselves, so we can navigate challenges from an inspired, creative, and embodied state of being.  Those that tend to this empowered form of optimism have significantly less stress than those who do not (Troy, 2015).   When we strategically use optimism to reframe our situation, we reduce our stress levels and lower our risk of developing a host of chronic health conditions (Aldao, et al., 2010). People who are more optimistic tend to live 11 to 15% longer than those who aren’t (Lee et al., 2019).   

Strategic optimism is not helpful if it causes us to accept painful circumstances that are in our power to change or if we use it to avoid feeling difficult emotions.  In fact, if we use optimism in this way, we may miss opportunities to tend to a wound that needs healing or to make changes that would benefit ourselves and others.   Using the R.A.I.N acronym (Brach, 2013), recognizing, allowing, investigating, and nurturing difficult emotions is the first step. Recognizing our emotions and perception(s) of the situation allows us to gain awareness of our reaction. Allowance engages the self-compassion required to make a space to feel (because we are worthy of such expression!).  From this compassionate space, we lean in with curiosity, eager to investigate, to learn more. Part of investigating is determining what we can change and control.  After tending to necessary emotions, it is then most helpful to take a significant action, which acts as the release port, relieving us of the suffering that flows from feeling incongruence.   By doing the significant thing, we build trust with ourselves as our spirit tends to the signals of the body, demonstrating to ourselves that we are worthy of such a significant effort.  In this way, we are prioritizing our wants and needs over those prescribed onto us by others.  Eventually, as we continue to do the significant thing, we deepen into secure attachment, which promotes a greater sense of coherence and congruence. If we cannot make a change to reduce our suffering, this is the time to accept, grieve the loss and optimistically resource and re-orient ourselves to the situation.  

The significant thing is different for every person and dependant on the situation and the unresolved wounds that it intertwines with.  Awareness of the significant thing comes from an embodied way of knowing (intuition), rather than the ‘figuring it out’ mind. It is the thing that takes the most self-compassion and courage, which requires the meaning of the significant action to overshadow the fear of taking it.  While we may fear doing to do the significant thing, often desperately trying to compensate by doing several other things in its place, ultimately, we will continue to feel out of tune until we act.  Finally, the significant thing if often subtle and may not directly involve others at all. It may involve writing a letter and then burning it.  It may mean making a phone call to make something right, enabling us to tune back into our sense of self-integrity after a violation (to self or others) occurs. 

The Significant Thing & Common Attachment Antidotes 

For those who tend toward avoidance as a reactionary (not intentional) coping strategy, the antidote to clear the incongruent feeling, typically manifesting as anxiety, is often a ‘reaching out.’ For those who tend toward anxious attachment to others as a coping strategy, the antidote often involves ‘reaching in.’ 

Working with our Negative Bias  

Optimism does not happen by merely thinking positive thoughts.  For it to be effective, we must intentionally immerse in a positive emotional state that enables us to shift our trajectory.  Once we embody a more positive state of being, we interrupt the fear and powerlessness associated with the stress response, which enables us to keep things in a more optimistic perspective.   

Most humans tend toward a negative bias, which means that when negative things happen, they have a greater impact on us and linger longer in our memory than positive ones (Gollan et al., 2016). While negative bias may help us when we are in danger, it is not so helpful when faced with day to day challenges.  To manage and even counter our tendency toward the negative, we need to consciously cultivate a more optimistic orientation.  To develop optimism, it requires a conscious effort to recognize when positive events happen and to take the time to immerse ourselves in the felt sense of them.  In time and with some effort, we can retrain our brains to automatically take notice of positive happenings in our day, balancing out our tendency toward the negative.    

“When one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one which has been opened for us” (Helen Keller, 1929). 

One moment at a time, one significant thing at a time, this is how we heal… 

By S.Dames and K.Hunter

They came upon the Cedar tree. It showed them the breadth of their centre and the strength and limitations of their shallow root systems.  While their resources span widely on the surface, when the drought and winds come, they feel fragile, wondering if they’re enough, if they have what it takes to survive the elements.

They came upon the Arbutus tree. It showed them their whimsical nature and the power of their magic.  Sprouting up like a fairy amid a forest of sameness. This is how they learned to embrace their uniqueness.  That a sprinkle of magic is exactly the medicine to transform their grief and shame.

They came upon the Maple tree. The fairy of the forest swayed before them, its tentacles reach joyfully to the sky, wrapped in an elegant moss jacket and bursting with foliage. This is how they learned to embrace their lightness, enabling them to dance with the fluidity of life. 

They came upon the Fir tree.  It struck them with its plainness. Its long thin trunk moving efficiently to the sky, wasting no time expanding on the surface.  This is a being that knows who it is, deeply rooted and resilient with nothing to prove.

They came upon the oak tree, all gnarled and alone, sending out seeds on the wind, trusting that only by falling to the darkness below could they sprout and live anew. 

They came upon the fallen tree, decaying and covered in moss, reverent at being the source from which new life will come.

And so they’ve come to learn that they too can feel messy, magic, stable, powerful, complex, basic and boring, carved out and teaming with life. That when embraced, they are the compost encouraging deeper roots and the seed from which new life springs…

I’m on this path. I’ve experienced this bliss. I know it’s possible…

When adversities from the past are emotionally unresolved, they remain with us, emerging as what we now call ‘trauma.’ When we heal these wounds, we remove the emotional charge from the associated people and events.  Without the emotional charge, the experience is simply a learning opportunity that cultivates depth, insight, and wisdom.  

Like a storm encourages deeper tree roots, when on a healing path, so too do past adversities encourage a more resilient constitution on the other side. Healing is the redemptive path, the re-writing of an old (and often painful) story from a place of genuine abundance.
 
Those of us who have spent a lifetime carrying around heavy emotional loads (trauma) experience great bliss when we develop the choice to lay it down (a product of healing).  This bliss carries us through the minor annoyances of life. It is the gift awaiting those who’ve spent a lifetime carrying a heavy load. This experience is so powerful that without any efforting at all, it accelerates the healing of others who continue to suffer beneath the weight of past adversities, and to a more conscious and compassionate human race. 
 
Let’s help each other put the loads down.  It serves everyone and it’s well worth the journey.

This mental health crisis is real and the stakes are higher than ever. By the age of 40, half of us resonate with a mental health diagnosis. Only 20% of those suffering from mental distress see any meaningful improvement with traditional biomedical treatment methods. 80% continue to suffer. It’s time to heed the evidence and shift beyond the outdated belief systems that keep us mired in ineffective mental health treatment methods. Dr. Crosbie Watler, a thought leader with decades of experience as a psychiatrist and mental health advocate, issues a call to action!

The Failed Promise of Modern Psychiatry

by Dr. Crosbie Watler, MD, FRCPC

The last decade of the twentieth century was a heady time for modern psychiatry.  Fluoxetine was released in the in the mid 80’s and many other so-called anti-depressants followed on its heels.  Though never proven, we touted the neurotransmitter deficit model for depression and truly believed that we were on the threshold of a major breakthrough in psychiatry and neuroscience.  In our collective excitement, we dubbed the 1990’s “The Decade of the Brain.” 

Fast forward to present day.  Despite widespread and often indiscriminate prescribing, on a per capita basis, there are far more persons off work on disability for anxiety and depressive related disorders than ever before.  The increase continues and is exponential.

There are two myths at play that serve to perpetuate the status quo.  First, is the myth of diagnosis in psychiatry.  In other areas of medicine, a diagnosis is a discrete, objectively verifiable condition.  There remain many symptom clusters that fail to meet this standard.  Lacking objective tests—much less treatments—the rest of medicine classifies these conditions as syndromes. 

Examples of common syndromes include Chronic Fatigue Syndrome and Irritable Bowel Syndrome.  In a desperate attempt to enhance the prestige of psychiatry—and as a requirement for billing the HMO’s in the US—the APA’s Diagnostic and Statistical Manual incorporates more diagnoses with each edition.  The belief that psychiatric diagnoses are defined constructs, on par with other areas of medicine, is the myth at the core of modern psychiatric practice.  Simply calling something a disorder, does not make it real (Joel Paris).

The image of a group of endocrinologists debating whether Type 1 diabetes should be a legitimate diagnosis is laughable, yet this is precisely how psychiatric “diagnoses” are minted.  If something is objectively real, we don’t debate its existence, and what was truth does not simply become untruth with the next edition of DSM.  The DSM committee meetings provide forums for so-called experts to lobby for their pet “diagnoses”, ones they feel comfortable treating and ones that will enhance their credibility and prestige. 

Further, if these diagnoses were real and credible, then why do psychiatrists so commonly disagree among themselves?  It is common to hear reference made to a psychiatrist’s particular “style.”  One psychiatrist’s Borderline Personality Disorder is another’s Bipolar Type 2, with entirely different treatment protocols. 

Lacking consensus on diagnosis, it is no surprise that the trajectory of psychiatric patient care is highly variable, depending on the bias of the treating psychiatrist.  Highly variable production systems operate at the expense of quality.  And who bears the cost of a highly variable system of care?  Certainly not the treating physician.  Most physicians are paid for face time, not for outcome.  This is akin to a contractor coming to your home and being paid for simply showing up. 

If strike one—so to speak—is that our diagnoses are syndromes, then strike two is that our medical treatments lack efficacy.  Given that we truly have no idea what we are treating in the first place, this should not come as a surprise!   An embarrassing and rarely mentioned statistic, is that our so-called antidepressants barely separate from placebo.  Further, we’ve since learned that many negative studies were simply mothballed (Lancet, 2012). 

What is truly incredible is that these medicines are still being marketed as anti anything.  If our antidepressants and antipsychotics lived up to their lofty promise, most psychiatrists would be out of work and the “treatment resistant” patients clogging our inpatient and tertiary care units would be promptly discharged.  This, of course, is not the case.  

Unfortunately, the public continues to drink from the punch bowl still being served by mainstream psychiatry.  How many times have you heard a friend recounting a visit to the doctor?

“The doctor says I have a brain disease called Major Depressive Disorder.  There is not enough serotonin in my brain, apparently.  He started me on Cipralex.”

Two months later you ask how she’s doing.

“Oh that medication didn’t work very well, I’m still off work.  My doctor added a second medication, Wellbutrin to ‘boost’ the first one, plus I’m on something to help me sleep…insomnia is a side effect of Wellbutrin.”

Two months later your friend stops by for a visit.

“My doctor thinks the reason my medications aren’t working is that I might have Bipolar Disorder.  He says there’s a ‘soft’ type that’s increasingly diagnosed these days.  He added a mood stabilizer.  I’m on four meds now and still off work.  I’m starting to lose hope.”

The above is played out countless times, day in and day out.  As a boomer psychiatrist, trained in the era of “biological psychiatry,” I soon realized that we were not healing patients in any substantive way with our medications.  We are creating life-long mental health care consumers.

We prescribe mediocre treatments for phantom conditions.  We cling desperately to the cloak of expertise and knowingness.  We have become less interested in the complex personal stories that might explain a patient’s suffering and inform non-pharmaceutical approaches.  We are quick to identify “disorder”, when the patient’s challenge might be a natural and logical downstream manifestation of upstream and primary causes.  This, to be fair, is a criticism that applies to other areas of medicine.

The conventional medical paradigm is rooted in the principle of specificity—a specific treatment for each discrete disease.  In common parlance, a pill for every ill. We are in an era of increasingly specialized medicine, where the physician puts his or her organ of choice on a pedestal, often treating the downstream symptoms as the primary condition.  When this fails—as it commonly does—psychiatrists often resort to desperate and toxic poly-pharmacy. 

Such prescribing is often the result of therapeutic despair on the part of the treating physician.  When a patient does not respond to treatment—and with physician’s ego on the chopping block—the doctor is desperate to do something, anything.  It seems that uninformed action is deemed somehow better than inaction. 

This demonstrates an all too familiar behavioural pattern and one not unique to the trades: when the only tool one has is a hammer, everything looks like a nail.  The hammer in this case is the prescription pad.  After many failed medication trials, the treating psychiatrist concludes that the problem lies with the patient, who is deemed treatment resistant.  The blame for treatment failure is projected onto the patient—they are treatment resistant. 

What of the possibility that we are simply using the wrong treatments?  Am we missing something?  Rarely are these questions at the table.  Curiosity and humility are simply thrown under the bus.  Above all, do no harm?  Also under the bus.  Despite all the claims for evidence-based and patient-centred care, the unavoidable and tragic conclusion is that the status quo works very well for the industry of care.  For the patients?  Not so much.

Much of what we do in clinical practice is simply “chasing smoke.”  We view the downstream symptoms as the primary condition.  Any first year medical student understands that fever is not a disease or disorder, it is a sign that there is something else amiss, something quite remote from the fever itself.  In medicine—and particularly in psychiatry—we often chase smoke. 

The majority of those labeled as depressed, are in fact distressed by the events in their lives and the stories they tell themselves about who they are.  Predictably, they fail to respond to our pharmacopeia.  Lost in the rush to increasingly specialized medicine, is the appreciation for the human organism as a whole.   We are the sum of our complex and interfacing systems, where symptoms in any one area might be secondary to remote upstream mediators.   The overarching clinical question then becomes, “Is this symptom the chicken or the egg?”

In our search for a better paradigm we might look to the wisdom of our ancient ancestors, from the Greeks, traditional Chinese, and yogi masters from thousands of years ago in India.  These teachings share the view that there is far more to us than meets the eye.  Am I my thoughts?  Is it as simple as, “I think, therefore I am?”  Who am I, really?  This question reflects our timeless quest for connection, identity, meaning and purpose. 

Connection with ourselves and with the world around us forms the bedrock of spritual health.  This new spirituality transcends specific religious affiliation and has spawned the phrase “spiritual but not religious.”  A holistic paradigm recognizes the importance of connectedness and is central to the Constitution of the WHO, wherein: “Health is a state of complete, physical, mental and social well-being and not merely the absence of disease or infirmity.”  Social well-being flows from a sense that we are connected with ourselves and with the world around us. 

The truth is, we were never evolved to live as we are.  We evolved to live in clans, with myriad connections to others, with each member having a purpose that supported the whole.  The price we’ve paid for the modern lifestyle, with all its conveniences and trappings of success, is profound disconnection.  There is a pandemic of distress and existential despair.  The boomers have chased happiness for decades.  Yet here we are.  Bigger cars, monster homes, extravagant vacations, on line shopping, cosmetic surgery… something, anything to make us happy. 

When our happiness remains elusive, we go to our doctor.  We are then given a simple checklist that confirms we are depressed.  Never mind that we really have no idea what depression is and its interface with normalcy.  Recognizing this dilemma, the ancient Greeks created a boundary between angst and melancholia.  Angst was a response to some life challenge and was inherent to normal human experience.  Melancholia was a distinct, profound and continuous depressive state that seemed independent of life circumstance. 

Until the 1980’s, a patient’s depressive complaints were classified as being either reactive or endogenous.  This parallels the ancient boundary between angst and melancholia.  Reactive depressive symptoms were much less likely to respond to medication and were referred for psychotherapy.  This important distinction was dropped from DSM 3 (1980).  We are entering the fifth decade of an ever-expanded and over-inclusive concept of mental disorders.  That this coincides with the introduction and aggressive marketing of novel “anti” depressants, is no coincidence.  We are in an era of medicalising distress, where most patients prescribed medications will fail to benefit (BMJ, 2013).  They will instead, exhaust themselves going down rabbit holes that are proven and guaranteed to fail.

Elements of a holistic model

We tend to see only what we are trained to see or are comfortable managing.  The decade of the brain has got us no closer to curing mental illness.  Over the past decade there has been a dramatic decrease in the release of new psychotropic medications.  It seems that even the pharmaceutical industry is throwing in the towel.  Tweaking brain receptors, split off from the organism as a whole, is simply barking up the wrong tree.  There is a better way. 

The body:

The benefit of movement and exercise for our mental and physical well-being is widely recognized.  We’re all familiar with the saying, “healthy body—healthy mind.”  A truly healthy body goes beyond the facade of one’s appearance or BMI.  Vital health is from the inside out. Central to this, is the mind-gut connection.  While the serotonin produced in the gut does not cross the blood-brain barrier, inflammatory cytokines certainly do, where they severely compromise serotonin turnover.  What triggers this inflammatory process?  We need look no further than the modern first-World lifestyle.  The standard American diet (SAD diet) is inflammatory.  The stress response is inflammatory. 

Food as medicine is not a new concept.  Hippocrates, considered by many to be the father of modern medicine, implored his patients: “Let food be thy medicine and medicine thy food.”  Beyond passing familiarity with our national food guides, which are obsolete even as revised versions are published, today’s doctors get little or no training in nutritional health.

How many psychiatrists do a food diary with their patients?  How many are aware that inflammation might be a significant perpetuating factor for a patient’s depressive symptoms, much less test for it?   How many are able to prescribe a specific nutrition plan that would support recovery and vital health?  Beyond being passive recipients of care, how many psychiatrists call on their patients to be active partners in their holistic recovery plan? My patients are consistently amazed that a psychiatrist is asking them what they eat and at being sent on their way with a lab requisition and a nutrition remediation plan.

The mind

If our brains can be compromised by processes external to the blood-brain barrier, is the reverse also true?  How do our thoughts and emotions impact our bodies?  Living in the first world, we are often in a state of heightened sympathetic tone—a state of fight, flight, or freeze.  This adaptation is deeply wired into our brains and served us well for most of our evolutionary history, where imminent threats to life or limb were not uncommon.  The threat would present itself, but once the threat was over—and if we survived—our nervous system would return to the restful state required for the body to heal and repair.

Fast forward to present day.  The threat is no longer the discrete and tangible tiger or rival tribesman.  Today’s threat comes from having the luxury to sit and think, or more accurately ruminate, about all the potential calamities that might come our way.  There is no such thing as stress, there is only the stress response to an external challenge.  Life is challenging, it does not have to be stressful—stress is a possibility

Stress is a reflexive protective response at the level of our limbic brain—more specifically, the amygdala.  In the absence of an objective threat to life or limb, the stress response is commonly triggered by the stories we tell ourselves—the so-called amygdala hijack (Goleman,1996).  While we might not completely eliminate the amygdala hijack, we can certainly influence what happens next.  Rather than simply being along for the ride, we can learn to pause, witness and reflect:  Am I using my brain, or is my brain using me (Tanzi & Chopra)?   We can redirect from thoughts that are not serving us, recognizing that there is no such thing as stress in the external world, there is only the stress we create in response to life’s daily challenges.

The stress response depletes the body in so many ways.  As is the case with the SAD diet, stress is inflammatory.  Chronic inflammation is an essential component of chronic diseases (Liu et al, 2017).   Beyond its potential negative impact on mood, high levels of inflammation are commonly seen with PTSD, along with a host of medical conditions including coronary heart disease, diabetes, cancer and dementia.  Stress compromises our immune response and in combination with our nutrient poor SAD diets, heightens our susceptibility to disease.   Even when not afflicted by a diagnosable illness, we feel depleted, lacking vital health. 

A common presenting complaint is the patient claiming to have anxiety, or beyond that, an anxiety disorder.  Generalized Anxiety Disorder is the diagnosis commonly applied.  Rather than invoking yet another disorder, we might explore whether the anxiety response is a natural and logical consequence of dwelling on contexts beyond our immediate control.  We don’t classify tennis elbow as a disease.  Tennis elbow is an overuse injury.  Anxiety could be reframed as an overuse injury—overuse of the mind.

If I have my hand on a hot element, I can take Tylenol for the pain, or I can take my hand off the element.  If I have anxiety, I can take Lorazepam, or I can learn Mindfulness Based Stress Reduction.  I can learn to meditate.  I can evolve, giving up patterns that no longer serve me.  I can take my power back, redirecting from worrying about outcomes I cannot directly control.  I can learn to quiet the mind, to think only when it serves me.  I can experience the healing that comes from alert thoughtlessness (Eckhart Tolle). 

The spirit:

Spirit—herein defined as connection—is identifying with something beyond the material world, the world of form of form (Deepak Chopra).  This connection has two poles—connection within (the intrapersonal) and without (the interpersonal).  We tend to be distracted by the noise around us, the external relationships.  We feel hurt or rebuffed when we perceive some narcissistic injury.  Brooding about about how others treat us, we fail to recognize that we are our own harshest critics.  We’ve incorporated so many messages, subtle and explicit.  We can’t even remember where the story came from, yet we keep telling it:

“I am not enough.”

“I am a failure.”

“If others really knew me, they wouldn’t like me.”

“I feel so guilty for my mistakes.”

“I hate myself.”

How is healing possible in such a toxic intrapersonal space?  It is not.  Without self-compassion, nothing else can take hold and flourish.  Not CBT, not the next antidepressant trial, not even the whole foods organic diet.  After almost three decades of psychiatric practice, I continue to be amazed by the prevalence of self-loathing.  In clinical practice, this is often the elephant in the room, akin to “Don’t ask, don’t tell.”  The patient is certainly not going to volunteer, “By the way doctor, I think you ought to know that I really hate myself.”  Conversely, the psychiatrist is unlikely to ask, “How do you feel about yourself.”  Lacking their own self-awareness, the psychiatrist would be very uncomfortable knowing how to respond in any helpful way to a patient’s intrapersonal despair.  

Fundamentally, most of us have no idea who we are.  How can we have compassion for something we don’t know?  Self-awareness is the foundation for self-compassion.  Our sense of self is highly conditioned.  We identify with our roles, relationships, successes and failures.  “I am a psychiatrist.”  No, I am not that.  Psychiatrist is a temporary role I play in the movie of My Life.  Who am I when I am not in that role?  Whatever handle we identify with, does it capture the essence of who we are, or is it something that can change?  If “I am a success,” then who am I when I fail? 

We have become so identified with the doing, that we’ve lost awareness of the being that is at our essence.  On the day of our birth we cannot avoid awareness of being.  There is no inner dialogue or story telling us who we are, or where we might me going.   Undistracted by the thought stream, we are immersed in the silent witnessing that is our essential nature.  This silent witnessing is central to the practice of meditation.  From the stillness of no mind, we are content and whole. We are freed from the insatiable quest for something to make us happy. 

Putting it all together

Radical change requires radical action.  Radical action is far-reaching and thorough—no stone is left unturned.  Our treatments fail not because our patients are treatment resistant.  Our treatments fail because they are not sufficiently radical.  We are a complex interface of biological, psychological, social, and spiritual components.  A radical intervention dictates treating all the components of health assertively and simultaneously.  In this context, a model reliant on simple symptom checklists as evidence for any primary disorder, is doomed to fail.  How could it be otherwise?

Dr. Crosbie Watler completed his MA at Lakehead University and worked in Atikokan and the Challenge Club in Kenora before going to Medical School at McMaster in 1988. He then proceeded to do his residency in psychiatry at Dalhousie University. Upon completion he then returned to Kenora from 1995 – 2001 and worked at Lake of the Woods District Hospital as Chief of Psychiatry. In 2001 Dr. Walter relocated to Duncan BC with his wife and their three children where he acted as the Medical Director for Island’s Health MHSU and the Dept. Head for Psychiatry. His medical practice required clinical expertise in multiple settings including, tertiary, inpatient, outpatient and ACT. Dr. Watler’s current interests focuses on incorporating the best of modern medicine with holistic/integrative health. Dr. Watler is an executive member of the Roots Program, forging new pathways to alleviate suffering related to mental distress.

Somatic intelligence refers to our degree of awareness and ability to interpret and respond to the sensations of the body (De Silva, 2017).  There are over 100 different bodily sensations, which are categorized as emotions, cognitive processes, or somatic and homeostatic states (Nummenmaa, Hari, Hietanen, & Glerean, 2018).  A core factor that differentiates humans from animals is an expanded consciousness, providing an awareness of the body, separate from the spirit that inhabits it.  Awareness of these sensations, coupled with the desire and confidence to respond, correlates with our somatic intelligence.

Nummenmaa et al. (2018) researched over 1000 participants to map out where the typical sensations are felt in the body. The illustration below is an excellent way to gain awareness and an ability to interpret and respond to the varying bodily signals.

When the spirit and body are securely attached (as described in the previous blog post),  we become inherently conscious and motivated to listen and tend to the sensations, desires, and concerns of the body.  This secure attachment is imperative to feel into our bodily sensations and navigate the stress response.  If we are not securely attached, and our ability to be aware of or respond to the body is hampered, we will continue to experience stress until we tend to the body’s concern.

Somatic intelligence refers to our degree of awareness and ability to interpret and respond to the sensations of the body (De Silva, 2017).  When the spirit and body are securely attached,  we Somatic intelligence refers to our degree of awareness and ability to interpret and respond to the sensations of the body (De Silva, 2017).  There are over 100 different bodily sensations, which are categorized as emotions, cognitive processes, or somatic and homeostatic states (Nummenmaa, Hari, Hietanen, & Glerean, 2018).  A core factor that differentiates humans from animals is an expanded consciousness, providing an awareness of the body, separate from the spirit that inhabits it.

When the spirit and body are securely attached,  we become inherently conscious and motivated to listen and tend to the desires and concerns of the body.  This secure attachment between the body and the spirit is imperative to navigate the stress response.  If we are not securely attached, and our ability to be aware of or respond to the body is hampered, we will continue to experience stress until we tend to the bodily concern.

To manage stress and the ripple effects it has on the body, we must first attain a degree of non-attachment. Non-attachment happens when we step back from the uncomfortable and often threatening sensations of the body, dis-identifying with them, so we can tend to them from a more objective and compassionate place. To do this, it is immensely helpful to develop the habit of talking to the body with unconditional positive regard, much like we would a dear friend. 

For the body to securely attach to the spirit it must believe it is unconditionally positively regarded. The ONLY way to come to believe it is regarded in this way is to test the relational container by being honest, showing up and speaking up authentically. When we do this with others and people respond by treating us as though we are inherently worthy, even if they do not agree with the opinions and behaviours that emerge on the surface, we gain trust and security in the relationship.

Much like testing the containers of our relationships with others is essential to believing we are unconditionally positively regarded by them, when emotional messengers present, the body is testing the relational container of the spirit. If we avoid, ignore, and will them to go away or BE something different, we continue to erode trust between the spirit and body and the messages persist, resulting in chronic anxiety, depression, and all sorts of unwanted behavioural projections.  The most unfortunate consequence of ignoring these felt senses is that we continue to promote a fracture between the body and spirit.  Conversely, when we respond with unconditional positive regard, receiving the emotional message like we would a welcome guest, the sensations don’t feel personal or threatening. Rather, it’s like sitting across the table with a dear friend, making space for them to share what’s on their heart, and providing the compassionate space for them to BE, FEEL, and soothe whatever arises in that moment.

When talking to a dear friend, we are clearly separate from them, they are an ‘other,’ which enables us to step back (non-attach). From this orientation, we don’t over identify with them, which prevents their experience from feeling threatening to us. Now, imagine your body and felt senses within are this dear friend. While they are welcome guests, they are ‘others,’ not essential to the spirit of who you are. As allies, they bring important information, feeling into and reporting on the subtle energies, premonitions, and incongruences that swirl within and around us. 

Each time we listen to the body, tending to the sensations and emotions that cue us, we promote secure attachment between the spirit and the body, healing the fracture that lies beneath our suffering. When you stop, notice, lean in and tend to your sensations and feelings you are expanding your awareness and practicing self-compassion, building trust with the body. In time and with practice, the body comes to believe it is unconditionally positively regarded by the spirit. When the body deeply believes it, secure attachment happens. When securely attached, the body and spirit reach homeostasis, awakening us to a new way of BEing, providing the equanimity and resulting peace that enable us to thrive.

Pause to Practice: Talking to your Body
A close up of a logo  Description automatically generatedWhen the body sends you a message, experienced as sensations and emotions, stop. Take a moment to notice what is happening, just notice. Lean in to really get a sense of it.  You might even ask your body what it needs and wants or what it is afraid of. Name what you are feeling. How would you describe it?

Notice how it feels when you put a name to what you are feeling. Is it a good fit? Does it need some adjustments?  Getting curious like this helps you step back (non-attach), keeping you from over identifying with the feeling. From this more objective orientation, you can hold space for the feeling, just like you would hold space for a friend who is sharing something important with you. 

Remember, for us to sustain any new beneficial practice, the felt reward must overshadow the felt effort (at least in general). How might you incorporate this new orientation in your day to day life?

This same orientation can help when conflict with others is activating the stress response.  If we can’t step back, we are likely to react with a harmful projection (directed inwardly or outwardly).  Next time you are in conflict and are feeling lost inside the stress response, how might you discuss the needs and wants of your body (and associated emotions, sensations) in a way that promotes non-attachment and self-compassion?

Interested in learning more and investing in your ability to securely attach? We partnered with Ladysmith Family and Friends to provide (FREE) virtual circles that promote unconditional positive regard and resiliency. Register by emailing Kate at: LaFFkateW@shaw.ca

Like trees, our roots intertwine amid a forest of others, enabling an opportunity to collectively resource, taking what we need in times of need and giving what we can in times of plenty. This pandemic represents an opportunity for humans around the world to come together to navigate a common challenge, mitigating this global threat before it becomes a chronic stressor.

Each of us has varying degrees of personal resiliency, reflected in the depth of our ‘roots’ systems. As a result, transient ‘weather’ systems will feel more threatening (stressful) to some than others. The ‘weather’ is the events, thoughts, and emotions that circle us, taking many forms, individually and globally.

In these rapidly changing and often chaotic situations, a common form of ‘weather’ is ambiguity. When ambiguity is high, it causes many of us to spiral into fear states that fester amid a sea of potentially threatening scenarios. Adding to the ambiguity, collective actions taken to navigate the potential threat can cause additional insecurity, and especially for those whose primary needs (food, shelter) are at risk. As a result, stress levels are high, which can lead to either chronic anxiety (sympathetic nervous system stuck on) or freeze, leaving us feeling disconnected and depressed (parasympathetic nervous system stuck on). By grounding collectively, as opposed to isolating individually, we are more likely to manage these common human challenges before they evolve into chronic stressors.

So…what does this look like?

On a practical level, at the risk of overcomplicating a complex topic, there are three evidence-informed qualities we can cultivate to promote personal and collective resilience in these collectively uncertain times:

  1. According to Polyvagal theory (Porges, 2011), we are more likely to regulate our stress and confidently manage challenges when we feel securely connected to others. For instance, in a pandemic scenario, while physical distance may be a requirement, social distancing is not. In this age of technology, we can stay connected to others, despite our physical limitations.
  2. To bolster sense of coherence (Antonovsky, 1979), we can expand our awareness of the plethora of inner and outer resources at our disposal. We can ground ourselves by taking an inventory of the structures (family, work, hobbies), assets (a safe place to live, food, warmth), activities (exercise, breathing, hobbies that bring joy), and relationships (those you feel safe to be authentic with) that help you feel resourced and secure amid the felt chaos. When we feel out of control, lost in a sea of insecurity, reminding ourselves of our resources is imperative. It is our resources that help us interrupt the stress response and that boost our confidence so that we can creatively navigate challenges that arise before they turn into chronic stressors.
  3. To keep us connected, preventing states of intense fight, flight, or freeze, we can use these uncomfortable emotions to cultivate habits that promote self-compassion (Rogers, 1959), or a greater ability to self-regulate and self-soothe when discomfort comes our way. We do this by showing up authentically, acknowledging and normalizing our suffering. When we pay attention to what is arising, we have an opportunity to provide the loving-kindness necessary to feel and tend to past and present wounds. This process begins with noticing when difficult thoughts and emotions arise, stepping back to recognize these stimuli as transient messengers, rather than overly identifying with them. With this stepping back (non-attachment), we are more able to provide loving-kindness to ourselves, much like we would a dear friend.

While urgencies and emergencies often feel threatening, they are excellent opportunities to brush off our resources, strengthen our sense of belonging in a larger community, and cultivate greater personal and collective resilience.