Thrive Mag Launch Issue by Thrive Mag

SPECIAL

LAUNCH ISSUE SUMMER 2012

VOLUME 01 | ISSUE 01

YOUR GUIDE TO MENTAL WELLNESS

: S R A L REGU

MOVE NIA | DO ASTAR METHOD | EAT HEALTHY OPTIONS RELATE BOUNDARIES | TRY REFLEXOLOGY

Contents summer2012

volume 01 | issue 01

MARK CAMERON

FEATURES 10 COVER STORY: Rahla Xenopoulos My Journey with Bipolar Disorder 14 Mpho Moshweu Fighting the Mental Illness Stigma 16 The Talking Cure How to Find a Therapist that’s Right for You 20 Anxiety The Low-Down on Anxiety and its Treatment 22 The Physiology of Stress The Effects of Stress on Body Chemistry 26 Festive Season Survival Guide Take the Holidays in your Stride

10 16

WIN!

See pages 13 & 46 for our fabulous book giveways!

28 Brain Chemistry Uncovered Neurotransmitters 48 Winston Churchill A Man Made Strong by Adversity

31 The Nia Technique Stop Exercising & Start Moving

33 The ASTAR Method Process Art

EAT

IN EVERY ISSUE 02 Editor’s Notes 06 8 Steps for Mental Wellness 08 Newsdesk

37 Healthy Options

09 Ask the Expert

RELATE

45 Inspiration

40 Personal Boundaries The Invisible Fence

46 Resources

TRY

47 Subscribe

42 Hand Reflexology

22 JEFF STEWART

MOVE

31 Summer2012 | 1

welcome volume 01 | issue 01

editor’s notes

MARK CAMERON

am so excited to be welcoming you to this launch issue of Thrive. A light bulb moment earlier this year has finally become a reality. I, myself, have been on a 30-year journey with bipolar disorder type 2, which has predominately manifested as recurrent depression. For at least half of that time, I didn’t know that I was experiencing an illness. I thought it was my fault; that I was a weak, fundamentally flawed person, who couldn’t cope with life the way everyone else did. A stigma still surrounds mental illness today, but 20 years ago, it was an immense source of shame and rarely talked about. So here we have the horrors of mental

“THERE IS NO SHAME IN BEING MENTALLY ILL – NOTHING TO FEEL GUILTY ABOUT.” I’d love to hear from you! email hello@ thrivemag. co.za

illness compounded by guilt and shame, making up a crushing burden that no one should have to, or indeed needs to, bear. It is for this reason that I am so passionate about the launch of Thrive. There is no shame in being mentally ill. There is nothing to feel guilty about. Mental illness is

biological – a disease of the brain, just as there’s heart disease, liver disease and lung disease. And mental illness, like any other illness, can be treated. Medication is often the first step. Use it to get better. However, to truly attain and maintain mental wellness, all areas of one’s life need to be addressed. On page 6, psychiatrist Dr Judy Bentley lays out the 8 steps for mental wellness, and Thrive aims to help you on your way. It won’t be easy, but my hope is that Thrive will inspire you to keep going. Remember to always be gentle with yourself. Accept where you are at and focus on taking ‘baby steps’. As the 12-step anonymous groups wisely say: “We aim for progress, not perfection”. My sincerest thanks go to all the fabulously kind and experienced people who have guided me every step of the way in the creation of this magazine. Without all of you there would be no Thrive. Big thanks also to Sue Jarvis of Pick n Pay Pharmacy, who at an early stage believed in the project, and took the leap of faith of sponsoring this launch issue. Happy reading!

Why just survive … when you can thrive with 2 | Summer2012

PUBLISHING EDITOR Jen Goy jen@thrivemag.co.za CREATIVE DIRECTOR & DESIGNER Angelique da Costa angelique@thrivemag.co.za SOCIAL MEDIA Jessica Hewson COPY EDITOR Anna Herrington PANEL OF EXPERTS Dr Judy Bentley MBChB, MMed (Psych) FCPsych(SA) Dr Neil Horn MBChB, FCPsych (UK) Engelie Brand MSc (Med App Psych), MA (Clin Psych) Equivalence Bradley Drake MSc (Clin Psych) Zureida Garda MA (Clin Psych) Dr Rene Jeannes M.Tech Homeopathy (Tech Wits) Beatrice Rabkin BSc (Nutr Med), Dip.Pharm Susan Roy ACC. PCD. Shona Saayman BSc (OT) Honours Nurain Tisaker BSocSc (Social Work) Honours ADVERTISING ENQUIRIES ads@thrivemag.co.za SUBSCRIPTION ENQUIRIES subs@thrivemag.co.za EDITORIAL ENQUIRIES info@thrivemag.co.za

LAUNCH ISSUE SUMMER 2012

VOLUME 01 | ISSUE 01

YOUR GUIDE TO MENTAL WELLNESS

MOVE NIA | DO ASTAR METHOD | EAT HEALTHY OPTIONS RELATE BOUNDARIES | TRY REFLEXOLOGY

ON THE COVER Rahla Xenopoulos PHOTOGRAPHY Mark Cameron ART DIRECTION Karen Nebe 4 | Summer2012

www.thrivemag.co.za and sign up for our monthly newsletter

Thrive Magazine

@ThriveMagZA

Need expert advice? Why not ask our expertâ&#x20AC;&#x2122;s panel at hello@thrivemag.co.za The most relevant and useful questions will be answered and published in the magazine as well as posted on the community page of our website www.thrivemag.co.za/community There are some questions that only someone else with mental illness can answer. Email them to

hello@thrivemag.co.za

Need support? Join in online discussions

www.thrivemag.co.za/

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What would you like to read about in Thrive? Email us on hello@thrivemag.co.za

YOUR STORY

IS PUBLISHED BY Turquoise Swan Media Pty(Ltd) PO Box 13551, Mowbray 7705

Have you suffered from mental illness at some point in your life? Are you willing to tell your story and inspire others? Email us on hello@thrivemag.co.za DISCLAIMER: The views and opinions expressed in this magazine are those of the contributors and not necessarily those of Thrive. Always consult a specialist before making any changes to your diet or medication.

Contributors MARK CAMERON shot the beautiful pics of Rahla Xenopoulos for Thrive’s launch issue. He has over 20 years of experience as a professional photographer, and has been published in most of SA’s top fashion magazines. Mark is married to Henri, who has bipolar disorder. He says “It has been a long road and there are many difficulties, but by the grace of God we get through them”. www.markcameronphotography.co.za

KAREN NEBE art directed and styled Thrive’s photoshoot with Marc Cameron. She has over 19 years experience in the retail, design and marketing arenas. She owns Pincushion, a company which facilitates production, art direction, marketing and events. karen@ pincushion.co.za

DAWN JORGENSEN took the pics for Thrive’s EAT section. She is a professional tour operator and describes herself as “an eternal traveller, photographer and natural beauty seeker”, with her heart lying in conservation. theincidentaltourist. tumblr.com dawn jorgensen@gmail.com

DR JUDY BENTLEY MBChB, MMed(Psych), FCPsych(SA) Judy is a psychiatrist in private practice in Cape Town. She is on Thrive’s Panel of Experts and wrote the article 8 Steps for Mental Wellness on pg 7. www.claremont neuropsych.co.za drjudybentley@ gmail.com

NINA MENSING wrote the article Talking Cure on pg 16. She is a photographer and journalist currently studying counselling psychology at SACAP. In 2010 her book Manic Marriage was published by Porcupine Press. She aims to live her life being congruent, genuine and accepting. ninamc8@gmail.com

JESSICA HEWSON is Thrive’s social media guru. She delights in her cyberspace adventures and wrote the Winston Churchill article on pg 48. She describes herself as a “word wizard” with the ultimate quest of using her voice to “sing, speak and write all journeys inwards and out”. jessicahewson@ gmail.com

ZUREIDA GARDA MA (Clin Psych) Zureida is a well-being consultant based in Johannesburg. She assists clients in exploring emotional blockages, drawing on her psychological training and using tools such as hypnotherapy, EFT and mindfulness. ztgarda@gmail.com 082 322 7073

DR RENE JEANNES M.Tech Homoeopathy (Tech Wits) Rene has been in homoeopathic practice for over 10 years and is currently based in Cape Town. She has a special interest in the treatment of depression and anxiety, and is on Thrive’s Panel of Experts. renejeannes @mweb.co.za

PERSONAL STORIES All personal stories in Thrive are real. However, due to the stigma surrounding mental illness, most people wish to remain anonymous. If you would like to make contact, email stories@thrivemag.co.za. Your message will be forwarded to the person concerned, but please note that a reply is not guaranteed. Summer2012 | 5

by Dr Judy Bentley MBChB, MMed(Psych), FCPsych(SA)

GET WELL

3 KNOW YOUR ILLNESS

1 SEE A DOCTOR If you have symptoms that are starting to affect your daily life, it’s time to see a doctor. Your GP is qualified to treat milder mental illnesses. However, if you have an illness such as depression that is causing you to stay away from work, is affecting your relationships, or that is recurrent, you need to ask for a referral to a psychiatrist who can give you a more accurate assessment and provide in-depth management. Your GP or psychiatrist will be able to refer you to a therapist for additional treatment, if indicated.

Knowledge is power! Get to know the symptoms, signs, and what you can expect from your illness. Briefly record what you are experiencing each day. This will keep track of how you are improving, and will show early signs of your symptoms worsening. This information is also extremely helpful to your doctor in assessing your progress. Research your illness and learn about ways to get and stay mentally well. However, make sure that the information comes from a reputable source.

2 TAKE YOUR MEDS NEED INSPIRATION?

See Thrive’s Regular Sections: EAT, MOVE, DO, RELATE & TRY! 6 | Summer2012

If medication is prescribed, take it regularly, as it is the only way to ensure that you get the response you want. If you have side effects, or notice anything unusual or undesirable while on the medication, speak to your doctor. Don’t just stop taking it. Stopping any medication suddenly can be dangerous or make you feel ill.

STAY WELL

5 MOVE Exercise has been proven to reduce stress and improve recovery from depression. Keep moving!

4 EAT Eat regular meals even if you have very little appetite. Little and often is good for you. Keep up your intake of fruit and veg, and try not to give in to the temptation to live off carbohydrate-laden pastries and sweets. Choose low GI foods. This regulates your blood sugar and improves the functioning of your brain. It is particularly important for people who experience a lot of anxiety. A little of what you fancy does you good - eat a square or two of dark chocolate daily. Omega 3’s help to protect your brain. Eat oily fish at least three times a week and/or take a supplement.

Remember: Always be gentle with yourself. Accept where you are at and set ‘baby step’ goals. Aim for progress and not perfection.

6 DO Sleep! Ensure that you keep regular hours as much as possible. Go to bed and get up at the same time each day regardless of whether it is during the week or on a weekend. Explore your creativity - your brain needs stimulation to keep healthy. Get outdoors and soak up as much light and sunshine as possible. Even better, exercise outdoors. Explore stress management and relaxation activities. Find what works for you and do it!

7 RELATE Being part of a community is good for your mental health. Improve your relationship skills, and nurture old and new friendships. Get involved in giving back to your community in a way that works for you. Don’t isolate yourself no matter how much you feel like retreating. Contact with friends and family gives perspective and energy. If possible, see a therapist regularly.

8 NURTURE YOURSELF You can’t give to others if you have nothing left to give. Take regular time-outs to recharge your batteries. Summer2012 | 7

summer2012

volume 01 | issue 01

FIGHTING THE STIGMA

1 in 5 people

will suffer from mental illness at some stage in their lives

Mental illness still carries an enormous stigma. As a result it is very often kept secret, which only serves to perpetuate it. This is despite the fact that it is estimated that at least 1 in 5 people will suffer from mental illness at some stage in their lives. However, the tide is turning. More and more people with mental illness are speaking out. Earlier this year, four British MPs went public with their experiences. Kevan Jones, a former Labour defence minister, spoke about Ruby Wax, his battle with obsessive compulsive disorder. a British comedian On being asked afterwards how his family, and depression sufferer, says: “Stigma is like the colleagues and constituents reacted, he said: pupil of an eye – “Whether it affects how people view me, I do not the more light that is know and frankly I do not care, because if it helps shone on it, the more it contracts”. other people who have a mental illness, or who have suffered from it in the past, then good.”

WORDS TO LIVE BY

In a recent conference focusing on strategies to overcome poverty and inequality in South Africa, Professor Crick Lund of the University of Cape Town said that the economic impact of not making proper mental health care available far exceeded the cost of providing it. He estimated that in 2003 South Africa lost about R30 billion due to lack of productivity and income caused by mental illness, compared to the R496 million the country spends on it every year. He said that contrary to the general perception that mental illness is only problematic in high income countries, or that poor people do not get depressed, South Africa actually has an extremely high incidence of mental illness, with every year one in six people experiencing symptoms. As the South African Federation for Mental Health says: “Mental Health is the Nation’s Wealth”. It is imperative that mental health is given the budget it deserves. 8 | Summer2012

“Be who you are and say what you feel because those who mind don’t matter and those who matter don’t mind.” – Dr Seuss

Psychiatry is known to be an inexact science. Everyone responds differently to psychotropic medication; therefore different drugs, in different combinations and at different dosages need to be tried until the right mix is found. However, all this may change. Andrew Leuchter, MD (a professor of psychiatry and behavioural sciences at the University of California) is heading up research into the possibility of using biomarkers - signals from our bodies that can be measured and evaluated with a blood test - to determine which antidepressants are most likely to be effective for a particular individual. The research is still in an early stage, but it is looking promising that the idea of personalised antidepressants may well become a reality in the not too distant future.

ASK THE EXPERT “I have had several episodes of depression and I am taking antidepressants. Will I ever be able to stop taking them?”

he answer most people would like to hear is: ‘Yes!’, but the real answer is: ‘It’s complicated …’ Depression means a multitude of different things. The first issue is to clarify what type of depression it is. The second is whether or not antidepressants are the appropriate treatment. Depression can be related to other health problems. When depression is recurrent, a medical checkup is important to ensure there isn’t any underlying thyroid or other health problems. Remember alcohol and drug use can lead to depression. Some depressive episodes are a response to difficult circumstances. When these circumstances change, or the management of the stress they cause improves, depression can remit. Mild to moderate depression responds well to psychotherapy. Cognitive behavioural and interpersonal therapy, if provided by suitably trained therapists, is especially helpful. Such therapy aims to understand the cause of the depression; the response to stress, difficult relationships or situations; and how that response can be changed. The problem is that psychotherapy is time-consuming and may be expensive and difficult to access, whereas antidepressant medication is comparatively cheap and a ‘quick fix’. If there have been several episodes of depression, mindfulness-based cognitive

DR NEIL HORN MBChB, FCPsych (UK) Neil is a psychiatrist with a special interest in bipolar disorder, depression, anxiety and cognitive therapy. He trained in the UK and works at UCT, Valkenberg Hospital and in private practice. neil.horn@uct. ac.za

therapy has been shown to reduce the risk of further episodes. However, therapy requires hard work, both on the part of the client and the therapist. Lifestyle changes such as healthy eating and regular exercise are also likely to reduce the risk of a relapse. There are a number of people with depression who find that a reduction in antidepressant medication makes them feel worse. Often this is the return of depressive symptoms, but it may also be due to the body adjusting to withdrawal from the antidepressants. It is difficult to distinguish between the two. Coming off antidepressants should always be done in consultation with your mental health practitioner. People with bipolar depression and those who have had severe depression or have been suicidal, should most definitely take medical advice before stopping antidepressants. Yes, it’s complicated and it would be wise to be carefully advised about your individual difficulties. Summer2012 | 9

10 | Summer2012

MARK CAMERON

Samuel, Rahla, Tallulah and Gidon

Rahla Xenopoulos – mother of 7-year-old triplets and author of A Memoir of Love and Madness and Bubbles, talks to us about her journey with bipolar disorder. Tell us about your bipolar disorder and diagnosis

A: I have bipolar disorder type 1 and have had many manic, hypomanic and depressive episodes. My first full-blown manic episode happened just before my 20th birthday but it took me 8 years to seek the help of a psychiatrist. When he diagnosed me with bipolar disorder, I felt extremely insulted and angry but after I thought about it and found out what the diagnosis actually meant, I felt incredibly relieved. It meant that all the insanity, bad debts, bad behaviour and extreme ups and downs, were not my fault, but actually an illness. Then came the realisation that I, Rahla, am a person and the illness is an illness, which is separate from me. It’s exactly the same if you have cancer – you are not cancer, but a person with cancer.

I had to acknowledge the responsibility of living with a chronic illness and that it would be with me for my whole life. I would have to learn to manage that, as well as manage the fact that sometimes the illness would manage me. I think surrendering control is a huge aspect of accepting the illness. I also realised, that instead of being the weak person I always thought I was, I am in fact actually stronger than most people. I am brave and capable of dealing with huge challenges. Coming to terms with my diagnosis took time, but it was also a revelation.

Q: How do you manage your illness?

A: I’m on medication and as I take my handful of pills every morning, I thank God! I have no tolerance for any different attitude. I know what it’s like on the other side and don’t want to go there again. I believe lifestyle factors are extremely important. I exercise at least 2 or 3 times a week. I have just got back into Bikram Yoga, which I love. I also occasionally walk up the mountain. I haven’t touched alcohol for 12 years. Correct nutrition is also a very big thing for me – my diet is dairy-free, low in sugar and low in gluten. I lead a very calm life (that’s in contrast with the party animal I used to be!). I wake up at the same time every morning and go to bed at the same time every evening. Summer2012 | 11

LIESL JOBSON/BOOKSLIVE

drugs. He gives me options regarding my treatment, so that I feel like a partner. You and your psychiatrist are not a catholic marriage – you can go and see another one. However, when you find someone that suits you, it’s important to stick with him or her. CLOCKWISE FROM TOP LEFT: Rahla on her wedding day; Rahla with sister, Pnina Fenster and mother, Iviah Fenster, at the launch of Bubbles; Rahla age 5; Rahla and family on the triplet’s 1st birthday

I can’t do sleep deprivation and I think that sleep is even more important than exercise. I am a great believer in routine, structure, stability and keeping stress levels low. I also have regular acupuncture sessions. I think it’s important to be holistic and find the right combination for your body. My body likes its pills, the needles and Bikram Yoga.

Q: Have you had any therapy? A: Therapy is not my thing. I did a bit, but got bored (laughs); although I do think it’s very good for a lot of people and I understand the role. I have a stunning psychiatrist and I talk to him. I guess that’s my therapy. He’s very human and caring and also very good with 12 | Summer2012

Q: When was your last episode?

A: In May last year I went into the first bad funk I’ve been in for 6 years. I had forgotten how completely awful it is. I spent 3 months in hell and was in Kenilworth Clinic for a few weeks. My psychiatrist tweaked the medication, but a lot of it was just waiting out the time. I’m all good now and I’m sure it won’t happen for at least a couple of years – or, as we always hope, never!

Q: Do you think something set it off?

A: We were renovating, which was stressful. However, I think that if we were renovating

now, I would be fine; but that day, that week, I didn’t cope. It was autumn, so the weather changing could have set it off – but I think if it was going to happen, anything could have done that. I think our bodies change over time and so one’s medication can stop working.

Q: What prompted you to ‘come out’ with having bipolar disorder?

A: I had no choice. We had just relocated to Cape Town. I had few friends here and Jason, my husband, was away. I fell ill and was forced to tell people. Later I realised that in order to be sincere with the world, to live my truth and have real friendships, I needed to reveal it. I think that every time I speak out about it makes it easier for someone else to do so. The more vulnerable you make yourself, the more vulnerable you enable other people to be. Often people think they’re being strong by holding it to themselves and dealing with it on their own. I think that’s such rubbish. Strength is in vulnerability.

Q: What motivated you to write your memoir?

A: I think the desire to help address the stigma attached to bipolar and mental illness. As a society we should be aspiring towards openness. We learnt that with AIDS. It’s not healthy to live with stigma. It’s not healthy to live with ignorance. You can run, but you can’t hide. This is what people actually have and it’s not going to go away. Ignorance is the greatest enemy of illness – one’s own ignorance and other people’s.

Q: Did you find it a cathartic process writing it all down?

A: Yes, but particularly afterwards, when I gave talks and experienced the warmth of people’s responses. There was so much love. I was embraced by the media and the feedback from the public was incredibly positive. I learnt that people want to have empathy – they want to understand. They may pretend otherwise, but everyone has had an experience of mental illness and are grateful to you for talking about it.

Q: Is there anything you would like to add? Q: Have you ever experienced A: I try to laugh at myself and my illness. It judgement? doesn’t diminish the suffering in any way, A: Yes. A lot of people just think I’m doing it for attention and that I must ‘pull my socks up’. My favourites are: “Rahla, you need a life coach” and “Don’t you think that everyone is a bit bipolar?” Actually no – not everyone is bipolar. That’s like saying everyone has cancer! A little while back, I went to a talk given by a high profile American psychologist. She said that depression was learned behaviour – that children watch their parents, see how they respond to stress and so learn to be depressed. No! I did not learn to be depressed. I grew up in a household that could not have been more joyous. No one wants to be depressed – it’s a physical illness. You do not catch it from your parents and you do not catch it from your friends.

but it does enable survival. There are stable times, there are good times, there are times of pain and there are times of absolute agony; but I think more than anything else, this illness has taught me to appreciate each good day, because I don’t know when the next one will be. If I had to choose a line that defines how I live, it would be: “Let the sunshine in”. When depression descends, it can get so dark and sometimes for so long, that it’s almost impossible to imagine there’ll ever be any light in your world. Then slowly, day by day, the universe allows little cracks to shine through. Eventually you wake up one morning and there are clouds and sun and blue skies and you wonder why it was ever dark up there. So I appreciate each sunny day, or at least aspire to appreciate each sunny day.

GIVEAWAY

Bubbles (2 signed copies) On a winter’s morning in 1949, in an empty field north of the city of Johannesburg, the lifeless body of a beautiful young girl was found by a passerby. She was identified as Bubbles Schroeder, 18 and she appeared to have been strangled. This is her story.

A Memoir of Love and Madness – Living with Bipolar Disorder (6 signed copies) Email win@thrivemag. co.za with your full name and phone number, as well as the title of the book you would like. Summer2012 | 13

MPHO MOSHWEU, 29, GREW UP IN NEWTOWN, A LOCATION IN GALESHEWE, KIMBERLEY, WHERE THE YOUTH FIGHT IT OUT IN GANGS & FEAR GOING TO SCHOOL. BUT MPHO’S BIGGEST BATTLE WAS OF AN ENTIRELY DIFFERENT KIND … Tell us your story

“DEPRESSION IS SEEN AS A WHITE PERSON’S ILLNESS, AND NOT FOR BLACKS.” 14 | Summer2012

As a boy I enjoyed school and was very active in school activities. However, I failed Grade 7 and it was then that my problems started. I lost faith in myself. I felt that there was no longer any point in trying with my schoolwork, as I would never amount to anything in life. From then on I did very badly academically. I became involved with the gangs in my neighbourhood and generally became a troublemaker. In Grade 10 I was suspended mid-year for fighting and soon after that I fell into a depression. I felt sad and empty most of the time and had difficulty concentrating on anything. I wasn’t able to talk to anyone about how I felt. I think most people just thought I was rude and lazy. Quite a few of my friends had quit school along the way and towards the end of Grade 11, in 2004, I decided

“RESOLVE TO BE A MASTER OF CHANGE, RATHER THAN A VICTIM OF CHANGE.” to follow them. I didn’t really have a reason for doing this; I guess I just didn’t care. However, at the beginning of the new school year, a friend came to visit and told me that the school principal, Mr Letselebe, wanted to see me. I thought he was joking. Why would the principal want to see me of all people? I had been a bad learner who had caused lots of trouble and I was finished with school. Yet for some reason I decided to go and see what he wanted. Mr Letselebe told me that he had decided to give me another chance. He believed I was capable of finishing school and passing matric but I needed to put in effort. I resolved then and there to make the most of this opportunity. At the end of the year I succeeded in passing. I am forever grateful to Mr Letselebe for believing in me. That is when I learnt my life philosophy: “Resolve to be a master of change, rather than a victim of change”.

What makes you willing to tell your story? There is such a stigma surrounding mental illness and I want to help change that. I want people to learn to respect those who are mentally ill. Also, mental illness affects all of us in different ways and at different times of our lives. It is important that people don’t see it as a death sentence.

How is depression and other mental illness viewed by your community? Depression is seen as a white person’s illness and not for blacks. People think you are just being lazy. They are not aware of the symptoms and that they can be treated. Often mental illness is

thought to be due to witchcraft – that the person is possessed by an evil spirit. Sufferers are often taken to the local witchdoctor to find a cure. When people talk of taking their lives, no one takes them seriously and yet we have an extremely high suicide rate.

How did you recover from your depression? I phoned SADAG (South African Depression and Anxiety Group) on their helpline quite a few times. They supported me. It didn’t take my depression away, but did help me feel less alone. I really only got better when I went back to school. Mr Letselebe spent a lot of time talking to me, trying to understand what was wrong. I started telling him about my problems. He played the role of a therapist for me. It was the best thing that could have happened to me and it completely changed my life. I opened up and no longer kept things inside. I stopped being so hard on myself. I saw a social worker for a few sessions and that also helped me get back on my feet.

Tell us about the work you are doing in your community I run a support group in my area. People, on phoning SADAG’s helpline, are referred to the group. Due to the stigma surrounding mental illness, these people often don’t want their friends and family to know that they are coming to a support group. I sometimes need to meet them in a secret place. I also run a youth support programme. We go into rural areas and educate people about mental illness. I am currently in touch with the Department of Education,

campaigning for more learner support in schools, so that emotional problems can be caught early and addressed.

What motivates you to do this community work? There is so much ignorance in my community regarding mental illness and as a result, people often don’t get the treatment they need, which frequently results in suicide. I want to help change this. SADAG also motivated me to start my own support group. I really enjoy being able to make a difference in people’s lives. Yes, there are challenges, but we cannot run away from them.

What are the challenges? We have a Department of Health that doesn’t understand mental illness. Despite having one of the highest suicide rates in the world, there is no budget for mental health educational programmes. In the Northern Cape, where I live, there are only 3 psychologists in the entire province and with a waiting list of at least 6 months. I would love to extend my educational programme to other areas, but I don’t have the resources.

Is there anything we can do to help? My programme is currently supported by SADAG. If people would like to help, please contact them on 011 2626396. Alternatively see their website www.sadag.org.za Have you suffered from mental illness at some point in your life? Willing to tell your story and inspire others? Email hello@thrivemag.co.za Summer2012 | 15

By Nina Mensing

HOW TO FIND A THERAPIST THAT’S RIGHT FOR YOU

16 | Summer2012

o what’s your problem? I mean that in a nice way, I really do. We all have problems. And if you don’t have any right now, chances are you will have them in the near future. Life is like that. It constantly throws curve balls at us. It could be a relationship problem, or difficulties with making a career choice. You could be suffering from low self-esteem, or grief from the death of a close relative. You and your partner might be disagreeing on how to discipline your children. You might be feeling depressed. You might be dealing with nightmares and flashbacks that remind you of a traumatic situation which happened in the past. You might be continually fighting with your mother. You might be feeling overwhelmed by the influence of others in your life. Life is like that. Life is challenging.

there, listening to the complaining. However, let’s not underestimate the value of empathetic listening. Really being listened to - sometimes for the first time in our lives - as well as feeling understood, can be extremely beneficial. Psychologists are experts in human behaviour. They have studied the brain, memory, learning, behaviours and why people act, react, feel and think the way they do. They can help people learn the skills of dealing with stress, how to function better and how to prevent problems. They can help a person deal with a one off traumatic event, or facilitate a long-term process of exploring emotions and behaviours.

“EMOTION, WHICH IS SUFFERING, CEASES TO BE SUFFERING AS THE THERAPY OPTION So what do you do when you have a SOON AS WE problem? Who do you speak to? Often, the problem with the problem is that FORM A CLEAR it feels as if there is no one to speak to, no one who understands. Isolation AND PRECISE and loneliness set in. A therapist might be the best person to go to, yet many PICTURE OF IT.” people don’t know where and how, to find the right one. People have sought – SPINOZA counsel throughout the ages – with their community leaders, priests, elders, family doctors, or a trusted older family member. These days, it is more usual to go to a trained therapist. In fact, it is now often those very family doctors, community leaders or priests, who might refer one to a therapist. The American media has oversimplified and ridiculed therapists. Everyone goes to their therapists to yadda yadda yadda on and on about every trivial detail of their life. The therapists don’t do much but sit

It’s a brave thing to do – to seek therapy. In certain cultures it is frowned upon. In others it is laughed at. Often people are thought to be weak if they are seeking help. However, most people who have been in therapy know what a brave journey it is; and those who have the courage to explore their interpersonal relationships, as well as their innermost feelings and emotions, usually end up stronger and happier for it.

TYPES OF THERAPISTS

PSYCHIATRIST A qualified medical doctor who has specialised in psychiatry and is able to diagnose and prescribe medication for mental disorders.

PSYCHOLOGIST Has a master’s degree in psychology and may specialise in various fields including clinical, counselling and educational psychology.

COUNSELLOR Has a diploma in counselling from a 2-3 year course of study and is able to help with guidance, marital counselling and family therapy.

SOCIAL WORKER Has a degree in social work and may work in private practice rendering therapeutic services and trauma debriefing.

Summer2012 | 17

CHOOSE A THERAPIST CAREFULLY

MY STORY

ANGELA* FOUND IT DIFFICULT TO FIND THE RIGHT THERAPIST. A trauma counsellor from the police station helped her tremendously, but could only see her for 2 sessions. Angela found a private therapist, but this person sat with what might have been intended as a look of compassion on her face, yet to Angela, seemed more like a look of horror. It made her feel like a victim and she never went back. The next therapist made it clear that she would work within a certain religious framework and immediately afterwards said something that made Angela feel judged. Another therapist had a clipboard on the arm of her chair and wrote constantly, whilst never taking her eyes off Angela. Angela found this very off-putting and so never went back. However, she persevered and finally found someone whom she could work with and this time she did go back. Angela realised that all therapists are different and work differently – instead of tarring them all with the same brush and never going to therapy again, she decided to keep looking until she found the right one. In the end, her perseverance paid off.

For us real people with real lives, real problems and real budgets, we need to carefully choose the therapist we work with. There is no guarantee that you will automatically get on with a therapist. You need to choose someone who is right for you. Working with emotions and feelings is a tricky business; nothing is clear cut or entirely logical. Spinoza, a Dutch philosopher said, “emotion, which is suffering ceases to be suffering, as soon as we form a clear and precise picture of it”. You want to find a therapist who is able to help you find that clear and precise picture. Going to therapy is a very personal and intimate experience. Issues and feelings are explored, tears are often shed and secrets are revealed. You want to feel completely comfortable with the person who is going to share this process with you. You want someone who understands, accepts and supports you. You also want to know that what you share will remain

confidential. You don’t want to feel judged, or belittled, or have to hear about the therapist’s issues. The appointment must be your space, to explore your options, with the help of the therapist’s professional insight. Personality clashes are a part of life. If this happens between you and your therapist, it does not mean the therapist is bad at what he or she does. It may simply mean that he or she is not the person you need to be working with at that given time. Everyone needs something different and it is a good therapist who can adapt their methods and techniques to suit the person sitting in front of them. Some therapists are more directive than others. Some use techniques such as bodywork, breathwork, journaling and art. Some give homework. Some therapists psychoeducate their clients. Some just listen and then find the right words to say at the right time to open up the client’s mind to possibilities. Some delve into the past and some prefer to focus on solutions.

SUSAN*, WHO WAS BATTLING WITH ANXIETY, ASKED A FRIEND TO ASK HER THERAPIST FOR A REFERRAL. For confidentiality reasons, she did not want to go to the same therapist as her friend. Susan’s main criterion for a therapist was for the person to be able to see her after working hours. She worked for a big corporation at the time and did not want her colleagues to find out she was seeing someone. Susan felt she would be more comfortable with a female therapist. After being referred to a few therapists by other therapists, she eventually managed to find someone who could see her after hours. It was a male therapist, but by the end of the first session, Susan felt comfortable enough with him to continue seeing him weekly. He made her feel heard and nurtured. Susan also felt that they spoke the ‘same language’. She enjoyed that he suggested reading material and workshops for her, involving her in the therapy process. She also liked his professional yet approachable manner.

QUESTIONS TO ASK 1. Where are you based? 2. What times do you work? 3. What age groups do you prefer to work with? 18 | Summer2012

4. Do you specialise in any specific problems, or run a general practice? 5. Do you have experience working in the field of … (specific to your needs)?

6. Do you offer short or longterm therapy? 7. What is your approach to therapy? How do you work?

MY STORY TRACY*, WAS UNABLE TO ASK HER FAMILY OR FRIENDS FOR ADVICE ON WHICH THERAPIST TO GO TO. In her coloured community, seeing a therapist was something that was not normally done. However, dealing with the loss of loved ones in her family, she felt that she needed to talk to a professional. She had no idea where to start looking, until she mentioned her idea to a colleague, who gave her a name. Her first impression of the therapist was over the phone and she felt comfortable with her decision to see that person before she even had the first session. When she met the therapist, Tracy felt immediately understood and accepted. Her underlying anxiety issues were quickly picked up and worked with. The therapist also allowed her to record the sessions, something that was important to her.

HOW TO FIND THE RIGHT THERAPIST FOR YOU

Referral

Through a word-of-mouth recommendation, you can find out a bit about the therapist, how he or she works and what kind of person he or she is. Therapists also generally prefer clients who come via personal recommendations or referrals from doctors. Erica Allison is a psychiatric social worker by profession and has been running a small private practice for 30 years. She has experienced that clients who have heard a bit about her before-hand and possibly how she works, come to her already feeling relaxed and confident in her abilities.

Test-drive

You might not know what you want and need from therapy until you have experienced it. The best way to find the right therapist is to make an appointment for one session, see how it goes and decide from there. It is advisable to go to this first session with an open mind. Ask the therapist how he or she works. Get to know what he or she is like and get a sense of whether or not you would want to open up to this person. By the end of the session you should know whether or not you want to go back.

Know & communicate your needs

“It is important to be clear on why you want to see someone and to communicate this to your prospective therapist,” says Clint Steenveld, a clinical psychologist. “Even if you are not sure what you need help with, it is important that you say this.”

In your area

Steenveld believes that finding a therapist in the area where you work or live is also crucial. Often therapy can be a long process. In order to commit to weekly or monthly sessions it makes sense that you need to be able to get to your therapist easily.

* To maintain anonymity, names have been changed and any further identifying details omitted. Due to the very personal and intimate nature of the therapeutic process, Tracy, Susan and Angela are unavailable for reader contact. Summer2012 | 19

by Bradley Drake

Ever been faced with an uncertain situation, where you worried a great deal, felt nervous and desperately needed reassurance?

BRADLEY DRAKE MSc (Clin Psych) Bradley is a clinical psychologist and founding member of the Centre for Cognitive Behaviour Therapy, Cape Town. He is internationally certified as a cognitive behaviour therapist and is an Associate Fellow of the Albert Ellis Institute in New York City. www.cognitivebehaviourtherapy.co.za

es, we’ve all been there. Anxiety, fear and even the occasional sense of panic, are an inescapable part of the human experience. While we sometimes use these terms loosely, they typically demonstrate a sense of distress and concern about something that we think is not quite going to go the way we would like it to.

DEFINITION Anxiety is best defined as a state of unease or apprehension. It is usually accompanied by a variety of physical symptoms, which can vary in intensity from mild to severe. These symptoms are due to the arousal of the autonomic nervous system and the resulting release of adrenalin.

ERS D R O IS D Y T IE X N A Specific Phobias e.g. fear of snakes Panic Disorder (with or without Agoraphobia) Post-traumatic Stress Disorder Social Phobia Obsessive Compulsive Disorder Generalised Anxiety Disorder

20 | Summer2012

Anxiety, fear and panic are always future-orientated emotional reactions, which are triggered by the presence of some sort of perceived threat to one’s well-being – perhaps physical (being attacked), perhaps social (being rejected and/or embarrassed), or perhaps mental (losing one’s mind/ going crazy). Fear and panic are seen as responses to a known, external, definite and immediate threat (e.g. a snake or a gun being pointed at you). This is opposed to anxiety, which is often experienced in response to an unknown, or more vague and uncertain threat, that is often not immediately present (e.g. possible end to a relationship or not finding a job).

COPING STRATEGIES These emotions are accompanied by an attempt to cope with the perceived threat. Sometimes coping involves escape of the actual situation - for example, moving swiftly away from a dangerous animal. With respect to worry, coping strategies often involve

actions that attempt to make the future more certain - for example, seeking reassurance from a love interest about their level of commitment, or in the case of a health anxiety, endlessly trawling the internet for information on possible outcomes. On occasion, coping strategies may also involve attempts to escape the physical symptoms of anxiety, as in the case of an individual who consumes alcohol or tranquilizers prior to delivering a speech. The emotional state of nervousness, anxiety or panic is in fact quite healthy when experienced in response to an objectively dangerous situation (e.g. four armed men jumping over the wall, walking across a snake’s path, or being informed of possibly losing one’s job) and/or when we perceive our ability to cope with this threat as inadequate. Our ability to experience these emotions is vital with respect to the planning of appropriate coping strategies and the survival of our species.

THE BIOLOGY There is a specific network of nuclei and neurons in various

areas of the brain, which are associated with fear. The part of the brain known as the amygdala, plays a pivotal role within this network and is considered to be central to the learning, memory and expression of fear. In monkeys, damage to this area of the brain renders them fearless in response to the presence of snakes - a response totally uncharacteristic of these primates. One can only imagine the implications of a species without fear: rapid extinction!

ANXIETY DISORDERS Anxiety and panic, together with their triggers, are normally temporary and fleeting. However, they can develop into a chronic state, with little relief. It is then that these emotions begin to affect normal functioning. This state of ongoing tension and anxiety, accompanied by an overestimation of threat and unnecessary avoidance, characterises anxiety disorders. A disorder is likely when a person has experienced symptoms of anxiety for an ongoing period, leading to considerable distress, and this has affected their ability to function at work or in general. Anxiety disorders are probably the most common of all mental health problems. According to a recent study in the United States, up to 28% of people will suffer from one at some point in their lifetime. In most cases, the disorder will already be present by mid-adolescence and three

“15.8% OF SOUTH AFRICANS WILL SUFFER FROM AN ANXIETY DISORDER AT SOME quarters of those who develop an anxiety disorder, will display POINT IN THEIR LIVES.” full-blown symptoms by their mid-twenties. Research within the South African context suggests that our population has a somewhat lower rate of anxiety disorders (15.8 %) and that they develop slightly later on in life. However, anxiety disorders are twice as common as mood disorders (depression and bipolar). What is most interesting is that the average age of onset of anxiety disorders is much earlier than that of mood disorders. This suggests that anxiety disorders probably precede the onset of mood disorders and left untreated, may account for a significant proportion of them.

TREATMENT The good news is that anxiety disorders are highly treatable. The most effective treatments have been shown to be cognitive behaviour therapy (CBT), medication, or a combination of the two. The most common medication prescribed is a specific class of antidepressant called selective serotonin reuptake inhibitors or SSRI’s. These may initially be used in conjunction with tranquilizers. However, tranquilizers, typically benzodiazepines, should only be used for short periods of time, as long-term use can result in tolerance, dependence and rebound anxiety when they are stopped. CBT is one of the real success stories of modern-

day clinical psychology. It adopts a learning based approach towards treatment. Therapy is initially focused on understanding exactly what sorts of triggers are responsible for evoking anxious thoughts. It then examines how individuals respond to these thoughts. Finally, the negative implications of avoidant coping strategies are examined. These strategies typically result in the immediate reduction of anxiety in the short-term, but actually exacerbate the disorder. The aim of the therapy is to change the way a fear provoking stimulus is thought about (cognitive restructuring) and to reduce avoidant behaviour (behavioural intervention). This promotes new learning around the triggers and a more accurate estimation of the level of threat they present, which ultimately leads to a reduction in the anxiety symptoms. A mental health professional, well trained in the assessment, diagnosis and treatment of anxiety disorders, is required for an accurate diagnosis of an anxiety disorder. Such professionals include psychiatrists, psychologists and general practitioners. The South African Depression and Anxiety Group can be contacted for referrals to appropriate professionals within your area.

SYMPTOMS OF ANXIETY OR PANIC Increased heart rate Cold chills or hot flushes Sweating Trembling Sensation of shortness of breath or an increased rate of breathing Chest pain or discomfort or a sense of pressure on the chest Nausea Dizziness or lightheadedness Numbness or tingling Difficulties with attention and concentration Restlessness , a general sense of tension, feeling on edge Feelings of unreality or being detached from oneself.

In the next issue: Obsessive Compulsive Disorder Summer2012 | 21

by Beatrice Rabkin

The effects of stress on your body chemistry

BEATRICE RABKIN BSc (Nutritional Medicine); Dip Pharmacy Beatrice practices as a nutritional therapist and has worked in the public health sector as a pharmacist. www.beatrice rabkin.co.za 021 686 4280 beatrice@rabkin. co.za 22 | Summer2012

or most of us the term stress implies an emotional state experienced when, for example, work, family or friends are getting us down. Stress is actually much more than this and often less visible. Stress is scientifically defined as physiological or psychological factors that cause healthy body functioning to be compromised. Included are physical factors such as food intolerances, inflammation, infection and nutritional deficiencies; as well as lifestyle factors such as smoking, too little exercise (or even too much exercise), too little sleep or too much alcohol. All these stressors can fundamentally disrupt

normal body functioning and biochemical processes, contributing to the development of mental illness.

NUTRITIONAL DEFICIENCIES One can live for years with susceptible genes and/or a nutrient deficient diet, with little, if any, negative effects. However, additional stress increases the nutrient demands on the body, resulting in the nervous system (or any of the bodyâ&#x20AC;&#x2122;s systems) no longer being able to function at its best. Therefore a seemingly minor stress trigger can bring about a sudden onset of mental illness. It becomes the straw that breaks the camelâ&#x20AC;&#x2122;s back.

MECHANISMS OF STRESS One of the mechanisms by which stress contributes to mental illness, is by the faulty absorption of food, making essential nutrients unavailable for the production of neurotransmitters. Emotional stress puts the body in a state of ‘fight or flight’ where digestion and absorption is not the primary focus of the body. Energy and nutrients are channelled away from these ‘unessential’ processes, towards the heart, lungs and limb muscles (for the genetically programmed and most likely not actual, flight). And so it is that chronic stress, highly prevalent in our society, can result in what amounts to a state of malnutrition. Stress also increases the metabolic rate, resulting in increased nutritional and energy requirements. This makes for higher demands on our nutritional intake, increasing the need for nutrient-rich foods. Sadly, this is probably the time when we are unlikely to spend the time making a healthy meal; instead we often reach for nutritionally-deficient sugary refined foods – the chocolates, biscuits and slices of cake. Another reason why stress contributes to mood disorders is that dopamine, the neurotransmitter

whose functions include motivation and reward, is used by the body to make the hormones secreted in times of stress - adrenalin and noradrenalin. And so, when we are stressed, there is less dopamine around, meaning a decreased sense of satisfaction on completing tasks and so less motivation and drive to do them.

CORTISOL, INSULIN & CYTOKINES Cortisol is another stress hormone and one of its functions is to increase blood sugar levels, making energy available for flight. In most of today’s stress situations, flight is not required and so blood sugar levels shoot up. What shoots up, must shoot down, and low blood sugar often results in the so-called ‘blood sugar blues’. High blood sugar levels also causes high insulin levels. Insulin is the body chemical which helps sugar enter cells, where it can be used for energy. However, insulin also encourages the deposit of fat around the middle (so-called visceral fat). These fat cells produce chemicals called cytokines which are associated with many of the key symptoms of depression: social withdrawal, loss of interest in sex, changes in appetite, disrupted sleep patterns and increased anxiety.

ANTIOXIDANTS Antioxidants deactivate body chemicals called free radicals. Free radicals are the by-products of natural cell processes, but are also produced by exposure to various environmental factors such as diet, smoking and radiation. Free radicals cause cellular damage which leads to the development of many diseases. In effect, antioxidants maintain health.

FOODS HIGH IN OMEGA 3 OILY FISH Sardines, salmon, mackerel, pilchards, fresh tuna

FLAXSEED Flaxseed and its oil

FOODS HIGH IN ANTI-OXIDANTS BERRIES

BEANS

FRUIT

VEG

DRINKS

NUTS

Blueberries, blackberries, rasp- berries, strawberries and cranberries

Red , kidney, pinto and black beans

Apples, cherries, pears, plums, pineapple and kiwi

Artichokes, spinach, red cabbage, sweet potatoes and broccoli

Rooibos and green tea

Walnuts, pistachios, pecans, hazelnuts and almonds

Summer2012 | 23

Qualified nutritionists are registered with SAANT (South African Association for Nutritional Therapists) www.saant. org.za

in the refining processes of grains and sugar. So the bottom-line is: eat your greens; and better still, complement this with a magnesium supplement.

HERBS RICH IN ANTIOXIDANTS

In fact, people suffering from clinical depression have been shown to have 40-50% higher concentrations of cytokines than people with a normal mood (although fat cells are not the only source of these chemicals). Cytokines are thought to promote inflammation in the brain, resulting in the development of mental illness. Eating the right foods and taking the right supplements can help decrease this inflammation. The best foods are cruciferous vegetables (e.g. broccoli and cabbage), spices such as cumin and turmeric and those high in antioxidants and omega 3 fatty acids. Prolonged exposure to cortisol can also cause increased growth of the amygdala, the portion of the brain that controls fear and other emotional responses. This contributes to a heightened expectation of environmental threats which could contribute to panic attacks and anxiety.

LIFESTYLE FACTORS Lifestyle factors which have been shown to reduce stress hormones, contributing to decreasing and changing the body’s response to stress, include: yoga, massage therapy, mindfulness, meditation, walking, breathing, laughing, power naps, smelling roses or lavender (flowers 24 | Summer2012

or aromatherapy oils), or any other aromatic smells, listening to music, and bathing in Epsom salts. Epsom salts contain magnesium, which is a relaxant.

Herbs have been used for centuries to reduce the body’s response to stress. These include Rhodiola, Siberian ginseng, ashwagandha, Ginkgo biloba and ginger. They are known as adaptogens. However, be sure to contact a professional for advice when using herbs, as they may be natural, but they can have powerful effects.

“Stress increases the metabolic rate, resulting in increased nutritional & energy requirements.” ROLE OF MAGNESIUM

SUPPLEMENTS

Magnesium is required for more than 300 chemical processes in the body and is vital in the production of stress hormones. However, it is also necessary for the production of serotonin, the neurotransmitter which plays an important role in regulating moods and sleep. When we hit the stress button, magnesium is taken away from making serotonin and given to the stress hormones, which can result in a serotonin level too low for the normal functioning of the brain. As a result depression and/or anxiety can develop. Magnesium is almost universally deficient in the modern diet, which is low in magnesium-rich foods such as green leafy vegetables, wholegrains, nuts and seeds. It is also often deficient in soil which is fertilised as opposed to composted and removed

Eating the right foods (and avoiding the wrong ones) helps our body manage stress. This goes a long way to creating and maintaining mental wellness. In addition to a healthy diet, I recommend that nutritional supplements are taken. It is important that a professional helps with deciding on the correct type and dose of such supplements, as this choice can often make the difference between getting better or staying sick.

FURTHER READING Nutrition and Mental Health: A Handbook M. Watts (ed) Traumatic stress: effects on the brain. Dialogues Clin. Neurosci. 2006;8(4):445–461 JD. Bremner Why Zebras Don’t Get Ulcers: A Guide to Stress, Stress-related Disease and Coping R. Sapolsky

by Zureida Garda

THIS IS THE TIME OF YEAR THAT IS ‘SUPPOSED’TO BE FILLED WITH JOY AND HAPPINESS. HOWEVER, FOR MANY OF US (PERHAPS EVEN MOST OF US) IT CAN BE EVEN MORE STRESSFUL THAN THE REST OF THE YEAR.

he year is ending and we are often burnt out, if not exhausted. Then we are faced with the pressure of Christmas shopping, worries about the economy, holiday travel and traffic, the mad crowds in the malls and maybe seeing family that we don’t really like or get on with. All the emphasis on family and togetherness can intensify any existing feelings of loneliness and isolation. We are also often reviewing the year we have had and maybe feeling the pressure or disappointment of not having achieved what we had hoped for. It is important to know that it is quite normal to feel stressed out during the holidays. Sometimes just knowing that can help us to stop pressurising ourselves to feel happy and jolly, when we are very definitely not.

PLAN OF ACTION So what is our plan of action to survive the holiday period? Here are a number of simple and effective practical strategies.

COMMIT TO YOURSELF As much as the holidays may be about family and taking care of others, we 26 | Summer2012

cannot do that unless we are taking care of ourselves. So the first step is to commit to yourself and make self-care a priority. Imagine for a moment yourself as a full glass that the stresses and strains of the year have emptied quite substantially. When you add to that the holiday worries, the glass becomes even more depleted, until you are virtually running on empty. Focusing on filling your glass helps to strengthen your resilience and stamina, so when you are faced with challenges you will feel better able to cope with them.

FILL UP YOUR GLASS First identify what you need to fill up your glass.

Take some time out just for you, even if it’s a few moments. Turn your attention away from everyone and everything outside of you and tune into yourself. This can help you have a better sense of what you are feeling and what you can do to meet your own needs. Examples of this are going for a short walk or taking a bathroom break so that you can be alone for a few minutes.

Doing things that make you happy. We should all do this at least once a day regardless of the time of year. Watch a favourite TV show, go for a walk, spend time in the garden, see a movie, read, chat to a friend, drink a cup of tea or coffee. It is important to be aware of what it is YOU want or need to do to feel good and this can vary from day to day. When you are engaged in the activity, be as conscious as you can be in the moment of feeling good, happy or comforted. It is this awareness that helps us to fill our glass, as we are consciously identifying and acting on doing something that makes us feel good. You can be playful with this too. Ask others what they do to make themselves happy and give those things a try. An easy and fun example is to get a colouring book and colour in! You can take it with you wherever you go and do it anywhere. This helps you to reconnect with your inner child and have some fun.

Get physical. If you have a regular exercise programme make sure you keep to it during the holidays. Over and above that, try and go for walks, play with the kids, go dancing, go shopping (that counts as walking!) and anything that gets your heart rate up. Exercise gets our lymphatic system moving and so clears out the toxins we’ve accumulated through the year. Exercise has been scientifically proven to help boost mood and alleviate anxiety. So do whatever you can do to make your heart beat faster and as often as possible.

Connect with a friend. If you need to vent and complain or just talk through whatever is going on around or inside of you, it really helps to be heard and understood by someone close to you. An added bonus is that being there to ‘hear’ another is also a great glass filler.

STAY IN THE MOMENT You may be feeling too overwhelmed, depressed or anxious to do any of the things suggested above. What then? One of the most powerful techniques to use at these times is to pull yourself back into the moment. Our thoughts are often wandering off in many directions: into the past such as previous holiday seasons or events that have upset you; or into the future and your plans for the New Year; or you may begin worrying about the dreaded ‘what ifs’ such as: what if my father embarrasses me in front of my new in-laws? To get into the moment, start by saying to yourself (out loud if you can), “STOP”! Focus on your breathing and on slowing it down. Count as you breathe: 1, 2, 3 as you breathe

in, 1, 2, 3, 4 as you breathe out. As your breathing slows down, you can increase the count: 1, 2, 3, 4 on an in-breath, 1, 2, 3, 4, 5 on an outbreath and so on. Slowing down your breathing signals to your body that it is not in crisis and it can begin to calm down. A number of psychological and meditation approaches use this mindfulness technique. All you have to do is think about this moment now and everything can begin to feel more manageable. You break things down into bite-sized chunks which helps you to feel less overwhelmed and more in control. When you are in the moment, look around you as if seeing everything with new eyes. Imagine you are a little child in a new place and allow yourself to tune into your senses as if you are experiencing it all for the first time. Examine familiar things in great detail, taking in colour, texture and size. When you focus on taking care of yourself and staying in the moment as much as possible, it gives you a strong base to work from, no matter what is happening around you. You begin to move from the centre of yourself and after a while discover that you are actually feeling calmer. In tune with your inner being, you are better equipped to take the holiday season in your stride, and arrive in January 2013 proudly flying the flag as a Festive Season Survivor!

TOP TIPS for Being in the Moment

Pick a leaf and look at its shade of green and the veins running through it.

Feel the temperature where you are. Is it warm? How does the sun feel on your skin?

Notice any smells around you. Are there fragrant flowers? Is there the smell of cooking food?

“IT IS NORMAL TO FEEL STRESSED OUT DURING THE HOLIDAYS.” 04 And always remember that you are not the only one who is struggling. Everyone else may seem to be having a good time, but more often than not, that’s not quite true.

Touch things, even if it’s just the chair you are sitting on.

* ZUREIDA GARDA, MA (Clin Psych) is a well-being consultant based in Johannesburg. See page 5 for details. Summer2012 | 27

BRAIN CHEMISTRY

28 | Summer2012

eurotransmitters – a group of brain chemicals – are the temperamental little critters that you need to have exactly the right amount of, and in the right locations, to keep the lights burning. When your GP or psychiatrist prescribes a certain psychiatric medication he or she mostly aims to establish the right amount of each type of neurotransmitter in your brain and body. Achieving this chemical balance is a finely tuned process as every person has a unique neurological profile. Also, as neurotransmitters are involved in brain activity, they can’t merely be counted in the same way as, say, red blood cells. Measuring their activity in the blood doesn’t provide useful information about brain function. You may have seen neurotransmitter tests advertised online, but Professor Dan Stein, Head of Psychiatry at UCT, indicates that there is no data showing that such tests are useful in the evaluation or treatment of mental illness. By having an understanding of how neurotransmitters function in your body, you may assist your doctor

in determining the right dosage and type of medication. Every combination of neurotransmitters affects a specific aspect of emotion, thinking and behaviour. By noting the effects on your brain and body, you may provide valuable feedback to your doctor, thereby helping to establish a suitable ‘balance’ of neurotransmitters needed for your mental wellness.

What are neurotransmitters? Neurotransmitters are minute and complex chemical compounds found in the spaces where your nerves connect. You will have heard these names before: dopamine, melatonin GABA, ACh and 5-HT. Their real names are to the lay ear, and I bet to half of health professionals too, an unpronounceable impossibility. Just try saying N-trimethylethanaminium! The scientific name for a neurotransmitter will be one which describes the different parts of its chemical composition. In everyday terms, neurotransmitters are mostly known by their acronyms – N-trimethylethanaminium (also known as acetylcholine) for instance becomes

WHAT DOES A NEUROTRANSMITTER REALLY LOOK LIKE UP CLOSE? On a scale this small, we can only imagine! In depicting neurotransmitters, chemists make use of graphic models. You may have seen these colourful ‘Christmas bauble’ models and stick man diagrams:

Ach, and 5-HT refers to a component of serotonin. Serotonin is likely the best-known neurotransmitter as it plays such a central role in treating depression. There are well over a 100 types of neurotransmitters – located not only in the brain, but in places all over the body. Interestingly, more serotonin will be found in your gut than in your brain. Neurotransmitters move along or in-between nerves and nerve endings. When travelling along the nerve, they are packed into pouches referred to as vesicles in which they move towards the synapse. A synapse is the contact area or junction between the various nerve cells (neurons) of the nervous system. Acetylcholine was the first neurotransmitter to be envisaged back in 1921. In 2010, a clear image of a synapse was obtained for the first time. One of the challenges in taking a photo of a synapse (apart from it being so small) is that it is forever moving. However, by using a newly developed rapid ‘freezing’ technique, scientists managed to obtain an image, showing the vesicles, the synapse and cell walls. Here serotonin is depicted as a ‘Christmas bauble’ model.

The acetylcholine stickman, depicted above, indicates its chemical elements (oxygen and nitrogen) and the bonds between them.

Summer2012 | 29

How do neurotransmitters operate? To get a mental picture of this complex process, you may well want to put on your 3D glasses! Think of it this way: your postman swims across a canal, letter bag over his shoulder. A DHL courier crosses the canal on a ferry and somewhere in between, is Chad Le Clos with a parcel on his back. The canal is the synaptic opening – the space between nerve endings – and on the other side of the canal a multitude of mail guys are awaiting the deliveries. Each is holding a mail bag (receptor) matching the exact size, shape and colour of one of the parcels the swimming postmen and couriers are delivering to them. The swimming postmen and couriers will keep searching until they find the matching bag in which their parcel will fit. It doesn’t stop there though. The mail guys will only carry the parcel to the next canal (synapse), and the whole process repeats. Certain routes (neuronal tracks) exist for specific ‘parcels’; the end result being the activation of a specific area of the brain or body. FIRST NEURON (Pre-synaptic)

Vesicles with neurotransmitters

THE SYNAPSE

Receptors

SECOND NEURON (Post-synaptic)

30 | Summer2012

“By having an understanding of how neurotransmitters function in your body, you may assist your doctor in determining the right dosage and type of medication.” Neurotransmitters therefore are messengers or couriers taking a command from the one nerve ending to the next, across the synaptic cleft. Sometimes the contents of the bags spill into the canal. The postman may then quickly gather it and take it back to the shore it came from (the so-called reuptake in SSRI’s). Or it will simply dissolve in the water and become fish food.

The complexity Thinking of neurotransmitters in this simplified way shows the importance of the exchanging and matching of different chemicals at the synapse. However, if you take into account the numbers involved in this exchange process, you can begin to appreciate its true complexity. There are at least 300 billion such ‘canals’ to be crossed and there are more than a 100 types of neurotransmitters at work. On top of it all, it’s a relay race, which also depends on the conditions of the canals - and the ‘mail men’ take only a few milliseconds to deliver their parcels and clear-up any spillages. Yes, it is an amazing race indeed! No wonder things can sometimes go awry. The biological phenomenon of a synaptic cleft, where different chemical substances can be relayed to several destinations, enables a complex set of behavioural combinations. Having these intricate interactions occur in the right place and at the right time, enables a person to choose from (or to at least experience) an optimised number of possible reactions. This gives us humans the ability to adapt to our world in the best possible way.

ENGELIE BRAND MSc (Med App Psych), MA (Clin Psych) Equivalence Engelie is a clinical and medical psychologist and psychotherapist with a keen interest in neuroscience. She is a member of the SA Clinical Neuropsychology Association and the SA Society of Clinical Hypnosis and practices in Cape Town and surrounds. 076 664 6000 EB Psychology

In the next issue: Brain Basics

JEFF STEWART

STOP EXERCISING & START MOVING

t’s common knowledge that exercise goes a long way towards creating wellness. However, for many of us that E word equates with boredom and hard work – something we should do, but would really much rather be lying on the couch watching re-runs of our favourite TV series. At best, we manage to drag ourselves to the gym every so often and at worst, live in a continual haze of guilt. But what if exercise was fun and perhaps so much so, that we could actually look forward to it? According to those who regularly do Nia classes, that’s exactly what it can be. With the credo of “stop exercising and start moving”, the Nia technique aims to turn the pursuit of health and wellness into the most fun thing you do in the day.

Nia can be described as the “best of fusion fitness”. Although it is often referred to as dance, it is actually a combination of dance, martial arts and healing arts. This makes up an east meets west approach to movement with the mind, body and spirit all in action.

BRIEF HISTORY Nia was created in the early 80’s in the US by Debbie Rosas and Carlos Rosas, in reaction to gym aerobics that was popular at the time. They took off their shoes, eliminated repetitive jogging up and down and called their practice Non-Impact Aerobics (and later Neuromuscular Integrative Action). The first letters of these phrases make up the word Nia – a rather unexciting explanation of a name that refers to a movement form which is anything but. However, Nia means “with

“Nia is the only fitness class I’ve ever found in which I can punch, kick, sweat, yell, dance, writhe, tiptoe, twirl, leap, squat, hit the deck, move slowly, crawl, stretch, slither, slide, meditate, improvise, heal and play … all in one hour.” – Nia student Juice! 7 steps for deepening the body mind connection based on the Nia Technique – K. Wolstenholme For a copy kathy@ niasouthafrica.co.za

Summer2012 | 31

JEFF STEWART

purpose” in Swahili, which describes it well, as that is exactly how it teaches people to move – the purpose being health, empowerment and, wait for it – pleasure.

PLEASURE PRINCIPLE Yes, it is emphasised in a Nia class that enjoyment is much more important than getting it right. There are “steps” to be followed, but these are fairly easy with most people getting the hang of it after a few classes. And if you happen one day to not feel like following the steps (say you’re depressed and finding it difficult to concentrate), no-one is going to

look at you askew. Nia is guided by the “Pleasure Principle” – if the body feels good, accepted and loved, it will naturally become stronger and heal. “Freedance” is also incorporated into the classes, where you can move just how the music and body dictate and truly dance as if no one’s watching (because nobody is!).

THE BODY’S WAY Nia is all about The Body’s Way, which is the practice of listening to the body. It encourages participants to modify the type, speed and range of their movement so that it feels right for them. As such Nia becomes

a personalised experience that everyone can enjoy, regardless of their fitness level. According to Kathy Wolstenholme, who hails from the US and brought Nia to South Africa in 2002, “Nia engages the spirit and touches people’s hearts, giving them permission to play and more intimately connect to themselves and with others – qualities rarely addressed in traditional fitness programmes. Nia encourages inner exploration and self-discovery and guides students to move through their own unique and infinitely creative space.” As Debbie Rosas, co-founder of Nia says: “Nia is like chocolate, you have to taste it”. And like eating chocolate, many people find they crave to do it time and time again, making it perhaps one of the best addictions there is. Give it a try. It might not be your thing, but it could transform your life. For more information, vidclips and classes in your area, have a look at www.niasouthafrica.co.za and www.nianow.com

MY STORY MY BODY TOOK ME BACK TO NIA. IF IT HAD BEEN UP TO MY MIND, I WOULD HAVE STAYED IN BED FOREVER. I had recently turned forty, ended a long term relationship and at the same time encountered some painful childhood memories. My life was wobbling. I could not find my feet or my place in the world. That was the beginning of my dark night – a severe depressive episode. When my therapist asked what I needed to do to feel 32 | Summer2012

better, my body answered, "go back to Nia”. And so I did. Although Nia didn't stop the process of my depression, it certainly held and contained me through it. At that point, I was functioning poorly and battled to get out of bed, but the one thing I could do was get myself to Nia. Some days I could barely move and cried throughout the class. However, Nia helped me feel grounded and connected to my body. It gave me time out

from my very busy, critical head. I also felt emotionally held and understood by the Nia community. Through relationship with the music, the movement, myself and the people I danced with, I started to heal. Each day it was a little easier to get out of bed, get dressed and step onto the dance floor. Slowly, letting the music wash through my body, the joy of movement made its way through muscle and bone and into my emotions. Placing one foot in

front of the other, I began to put my life back in order. Right now, when I dance, I am in my body, my heart is opening, I am connecting more to myself and my mind is resting. Those moments, when nothing matters, except me in movement with the music, are a precious part of my week and a vital part of my commitment to my own transformation. – GV To contact GV, email stories@thrivemag.co.za See page 5

“ by Gail Walmsley

AWAKENING SPIRIT THROUGH ART

When my daughter was seven years old,” says artist Howard Ikemoto, “she asked me one day what I did at work. I told her I worked at the college, that my job was to teach people to draw. She stared back at me, incredulous, and said, “You mean they forget?” We are all born with the ability to create. As children, we instinctively mirror our environment and our experiences, telling our stories through pictures and paintings. Summer2012 | 33

none existed. Step by step our inner creative fire (as unique and personal as our own thumbprint) is stomped out.

BUT THERE IS HOPE! With respect and kindness we can learn to set aside our judgements. With the quietening of the voice saying “I can’t draw/paint/write”, we open ourselves to renewed possibility. We can give ourselves permission to create – permission to step into boundless play.

“WE ARE ALL BORN WITH THE ABILITY TO CREATE!”

GAIL WALMSLEY Gail Walmsley is an ASTAR trained facilitator and a Nia white belt instructor. She utilises dance and movement to enhance mindfulness, health and wellbeing as well as art-making processes to develop awareness, intuition, flexibility and non-judgement. www.heartin motion.co.za 34 | Summer2012

Ask young children if they can draw, act, paint, sculpt, dance and the vast majority will jump up and down excitedly proclaiming, “I can! I can!”. Ask a group of adults the same question and count the few hands that tentatively rise.

SO WHAT HAPPENED? Where and how did we lose the faith in our creative ability? At school and at home we are often marked, praised, belittled and judged according to someone else’s standards (our teachers, our parents and our classmates). Gradually we begin to believe these judgemental voices and develop our own personal critic, unconsciously erecting walls where

The ASTAR method was developed by Lindy Solomon. A Capetonian, who has been involved with art education, curriculum development and teacher training for over 25 years, she became aware of the enormous healing power of art. She also witnessed the free, spontaneous art-making of children, who created without expectation or judgement. Through extensive research and development in methods to aid free authentic expression, the practice of Awakening Spirit Through Art (ASTAR) was born. As we are creatures of habit that can so easily swing back into old patterns, how do we keep the selfcritics at bay? The ASTAR method does all it can to bypass the thinking, analytical mind – painting with eyes closed, drawing with the nondominant hand, focusing on sensation and feeling – anything to confuse the linear mind and stop the critical voices. The focus is taken away from the end product and instead the very act of creating is celebrated. No longer is it important what is created, but how it is created. When we can let go of creating something for its outcome value, then the all-consuming weight

of success vs failure is released and creation with freedom and spontaneity is made possible. ASTAR-trained facilitators ensure that a safe, supportive and nonjudgemental environment is created to allow free, authentic expression to bloom. The space is cleared of competition or comparison and in its place, filled with inspiration and encouragement.

STREAM OF CREATIVITY Once we set our critics aside and feel safe to step into the unknown, we can slip into the stream of creativity. We can be in the present moment, thinking in pictures and processing information through our senses. Our job is just to step out of our way and let whatever bubbles to the surface move onto the page. Creating in this manner, besides being satisfyingly enjoyable, deepens awareness of ourselves. A creative conversation begins. We now have an opportunity to access aspects of our self that have been unseen, denied or buried. Art becomes a medium of discovery, challenge and change. It becomes a catalyst for personal growth and healing, encouraging us to tell our story through art.

WISDOM & MAGIC If you are reading this article and feel a stirring from deep inside, don’t ignore it. It could well be your inner child jumping up and down, begging you to smear paint-filled fingers across a canvas. You were born with the understanding and knowing to create. As Picasso said, “It took me twelve years to learn to draw like an adult and the rest of my life to learn to draw like a child again”. Bring back the spontaneity and wonderment of your inner child – there is profound wisdom and magic in it!

MY STORY I AM A PROFESSIONAL WOMAN, 45 YEARS OF AGE, ARTICULATE, INSIGHTFUL AND USUALLY WITH A GOOD SENSE OF HUMOUR. However, since my early teens, I have struggled with recurrent depression and post-traumatic stress disorder. I was first diagnosed in my thirties when I saw a psychiatrist and he prescribed an antidepressant. This was to begin my on/off relationship with medication, resulting in numerous relapses. I thought I was on track, taking the medication as prescribed, when, towards the end of 2010, I experienced a serious setback. I was forced to seek psychiatric input again and am now on another antidepressant and doing well. Previously I tried to convince myself that the depression was not a part of me, blaming the painful cycles of anxiety and despair on hormones, severe stress and traumatic life events. I could not accept that I had some recurrent illness. Only now am I finally accepting my diagnosis and the fact that I have to remain on medication, at least for the foreseeable future. My first experience of the ASTAR process was a gift, given to me by a friend who is an ASTAR-trained facilitator. She invited some of the special women in her life to attend a workshop on Women’s Day and what a gift. Years later I continue to open and unfold it. I have become a true ASTAR ‘junkie’, attending whenever finances and schedule allow. ASTAR has provided me with a safe and containing space to access and act out feelings that I have a tendency to repress. I have experienced some

subtle but significant shifts in the process. I once arrived late at a session in a deep and overwhelming rage. I stood at the entrance gate in the rain, so ambivalent, I almost fled. However, in the space of the three hours ahead, I managed to channel all this frustration and churning anger onto some inanimate object in my hands – a sculpture that took on such a form and a colour so bold and bright, that I, in particular, was astonished at its dazzling brilliance. I left the session feeling quite elated and full of joy and pride. The opposite may happen. I may be tackling a task in a carefree mood and become aware of painful and sad feelings welling up inside me. It is extraordinary how effective the process is in moving these uncomfortable feelings through and out. It’s as if the act of creating and exploring is in itself a catharsis, a healing. The final product or image is there – outside of me – and quite liberating. My ASTAR facilitator gently and tenderly guides the creative process so that I always feel emotionally held and nurtured. An added bonus is that the contact and exchange with other people in the process, creates a feeling of shared experience and community. Although ASTAR speaks to ‘Awakening Spirit through Art’, I can testify to its lightening of my spirit. It helps me to live joyfully, to be present and free. – LH To contact LH, email stories@thrivemag.co.za See page 5 for more info.

For more information on the ASTAR method, see www.astar.co.za. If there are no ASTAR facilitators in your area, look for classes that offer Process Art. Summer2012 | 35

RICH IN ANTIOXIDANTS

HEALTHY OPTION Serves: 4 Cost: R50

Vegetable & Bean Salad with a Creamy Garlic & Mustard Dressing

Recipe: Beatrice Rabkin | Photos: Dawn Jorgensen

METHOD Soak dried beans for 3 days, changing water daily and

adding a squeeze of lemon Rinse thoroughly Place in pot with plenty of water, bring to the boil and

INGREDIENTS 1 cup dried white beans 1 small cauliflower 1 small broccoli head 3 medium carrots, julienned 100g mangetout or fine green beans

DAWN JORGENSEN

FOR DRESSING Half a cup of plain yoghurt 3 tbsp olive oil 1 tbsp balsamic vinegar 1 tbsp Dijon mustard Crushed garlic, to taste

simmer until cooked â&#x20AC;&#x201C; about 1 hour Set aside Break cauliflower and broccoli into small florets Steam each vegetable separately (they each take different times) until just al dente (see note on steaming below) Add beans to the cooked vegetables Whisk together dressing ingredients Pour half of the dressing into a salad bowl Add vegetable and bean mixture to the salad bowl Add rest of the dressing and toss The dressing can be used for cos lettuce, as well as to make a traditional or vegetable caesar salad, or any other salad which is robust enough to handle a strongly flavoured dressing.

FOR STEAMING* Ensure that the water is boiling rapidly before adding

the vegetables to a steamer basket. Turn heat down to cook the vegetables. Ensure the steamer has a tight fitting lid. *Steam vegetables for maximum nutrients Summer2012 | 37

DAWN JORGENSEN

RICH IN ANTIOXIDANTS

Cabbage ‘Pasta’

INGREDIENTS Half a green cabbage 2-3 cloves garlic, crushed 1-2 tbsp olive oil or butter

FOR DRESSING 1 medium onion, peeled and diced 2-3 cloves garlic, crushed or finely chopped Chilli flakes (optional) 1 can of tomatoes, peeled and diced Handful of fresh basil, oregano or marjoram, chopped 250g feta cheese, cubed

with TomatoSauce and Feta Recipe: Beatrice Rabkin | Photos: Dawn Jorgensen

METHOD

HEALTHY Slice cabbage in ribbons to resemble pasta OPTION Rinse and do not dry Heat butter or olive oil in a large pot Serves: 2 Add cabbage and garlic Cost: R30 Cook covered over a very low heat until cabbage is wilted Put cabbage aside Sauté onion, garlic and chilli (if using) in a little olive oil, over medium heat Add tomatoes and cook until they reduce to a sauce consistency Add freshly chopped herbs Pour sauce on top of cabbage and sprinkle cubed feta on top.

ALTERNATIVE OPTION Use broad beans, asparagus and broccoli with pesto and cream as an alternative sauce. Summer2012 | 39

by Nurain Tisaker

H NURAIN TISAKER BSocSci (Social Work) Honours Nurain is a clinical social worker in private practice. She is a specialist in the fields of addiction, eating disorders, mood and anxiety disorders. 073 825 8372 nurain.tisaker@ gmail.com

FURTHER READING Boundaries: When to Say Yes, How to Say No H. Cloud & J. Townsend Boundaries and Relationships: Knowing, Protecting and Enjoying the Self C. Whitfield

40 | Summer2012

1. Physical Boundaries

ealthy personal boundaries make for healthy relationships and healthy relationships enhance mental wellness. However, before we can set healthy boundaries, we need to understand what personal boundaries are.

These help us determine who we allow to touch us and under what circumstances they may do so. In the general sense, physical boundaries also include the clothes we wear and who we allow onto our property and into our private physical space.

WHAT ARE PERSONAL BOUNDARIES?

2. Mental and Emotional Boundaries

In the literal sense of the word, a boundary is a dividing line that separates one area from another. Unless a boundary is clearly marked by a fence or a road, we can never be entirely certain where one area ends and the other begins. In a similar way boundaries can describe limits and rules in relationships. We own our lives and should be responsible for and protective of them, keeping the good in and the bad out. A boundary is a â&#x20AC;&#x153;personal propertyâ&#x20AC;? line that marks those things for which we are responsible. In other words, boundaries define who we are and who we are not, what is ours and what is not ours.

These give us the freedom to have our own thoughts and opinions. Emotional boundaries help us deal with our own emotions and disengage from the harmful, manipulative emotions of others.

BOUNDARIES IMPACT ALL AREAS OF OUR LIVES AND INCLUDE THE FOLLOWING:

3. Spiritual & Religious Boundaries These help us to establish our own personal experiences and values as well as the relationship we may share with a Higher Power or God.

HEALTHY BOUNDARIES Healthy boundaries make it possible for us to separate our own thoughts and feelings from those of others and to take responsibility for what we think, feel and do. This means that we can set limits in our relationships and indicate how far we are willing to go within our own level of comfort. Essentially,

healthy boundaries help us take care of ourselves. Healthy boundaries are also flexible. In trying to protect ourselves, we may keep very rigid boundaries, trusting no one and not allowing anyone to get close to us emotionally. On the other hand, in our search for love and acceptance, we may leave ourselves too vulnerable, becoming too trusting and letting people hurt us too easily. Flexible boundaries mean we accept people and actions that are positive, helpful and needed, but protect ourselves from people and actions that are harmful or that interfere with our lives. Flexible boundaries give us the choice of who we trust and how much we trust those people, enabling us to have positive relationships, while protecting us from abuse. They pave the way to true intimacy. Also, if we have healthy boundaries, we are able to set appropriate limits on what we do and say to others, respecting their rights as well as our own.

UNHEALTHY BOUNDARIES Unhealthy boundaries often emerge from dysfunctional family backgrounds. The needs of parents, or other adults in a family, are sometimes so overwhelming that the task of

raising children is demoted to a secondary role and dysfunction is the likely result. Consider the role of the mother who, as a way of dealing with her own anger, screams at her children or becomes physically abusive. Her needs come first and the needs of her children – for safety, security, respect and comfort – come second. In this situation, the children are likely to learn that boundaries do not matter. As these children grow up, they lack the support they need to form a healthy sense of their own identities. They may learn that if they want to get their way, they need to intrude on the boundaries of other people, just as their mother did. They are likely to grow up with fluid boundaries which may lead to problematic relationships later on in life. On the other hand, these children may learn that rigid and inflexible boundaries are the way to handle their relationships with other people. To protect themselves, they may wall themselves off from other In the people and as a next issue: consequence, How to Set find it difficult to Healthy form close bonds Boundaries with others in adulthood.

“BOUNDARIES DEFINE WHO WE ARE AND WHO WE ARE NOT, WHAT IS OURS AND WHAT IS NOT OURS.” Do you have Boundary Problems? You are likely to have problems with boundaries, if you answer yes to any of these questions: Do you feel guilty or afra id when trying to set boundaries with others? Is it hard to say no? Do you feel mean or unloving when you attempt to set boundaries with others? Do you have difficulty deciding how much time, love or money to give away? Do you feel that setting boundaries is really just being selfish? Summer2012 | 41

by Suzanne Leighton

SUZANNE LEIGHTON BSc, MSc, PMP Suzanne is registered with the Allied Health Professions Council of South Africa. In her Cape Town practice she uses massage in conjunction with counselling and has a special interest in mental health. 084 293 3 214 suzl@mweb. co.za 42 | Summer2012

PROMOTE WELLNESS WITH A HAND MASSAGE? HARD TO BELIEVE?

ot at all, say reflexology practitioners. It certainly can do this. What’s more, recent research has backed up this claim and reflexology is fast becoming an accepted therapeutic treatment. A recent British study found reflexology to provide beneficial effects on “women experiencing a need for emotional support”. Fifteen women received 30-minute reflexology sessions for 8 weeks. The

findings included improvements in mood, self-esteem, confidence, motivation, concentration and relaxation levels. The exact way in which reflexology works has not yet been completely scientifically proven. The theory is that there are energy channels in the body. When these channels become blocked causing energy to become stuck, illness results. This theory underlies most medical practices originating in the east, such as acupuncture.

D O H T E M D N A H E TH Lung/Breast/Back Heart Eye & Ears

Eye & Ears

Bronchial Lymph Drainage Back Muscles

Pituitary

Brain

Brain Arm & Shoulder Diaphragm

Head

Spleen

Throat Neck

Stomach & Pancreas Gall Bladder

Cervical

Liver

Thyroid

Intestines

Thoracic

Sigmoid Flexure

Adrenal

Bladder

Kidney

Coccyx

Lumbar

Ovary/Testicle

Uterus/Prostate

Pelvic Area

Lymph/Fallopian Tube/Groin

Left Hand The fingers represent the head, the raised ridge below the fingers represents the chest and the palm of the hand represents the abdominal area. However, the whole hand should be covered in order to treat the whole body.

Right Hand

Start on the fingers. Work on each finger from the tip to

the base, palm up and palm down. Using your index finger, press on the tip of the recipient’s

finger. Gently, but firmly, roll your finger from side to side and front to back. Move a few millimetres down and repeat. When you have covered the fingers, move on to the palm. Using your thumb, press below the base of the finger and

Reflexology maintains that there are points in the hands and feet corresponding to every part of the body. These points are known as reflex or pressure points and when they are pressed, energy in the body’s energy channels is shifted. This stimulates the body’s natural healing powers, resulting in the relief of the symptoms of stress, illness and pain. Reflexology can be safely used in conjunction with other medical treatments. It may also be effective for promoting good health and preventing illness.

roll from side to side and front to back. Move a couple of millimetres down and repeat. Do this in a line from the finger to the wrist. Repeat the process until the whole of the palm has been covered. On the top of the hand, use your index finger to press in the same way, in each web and along the depression between the finger bones. Finish with a massage of the whole hand using movements that are gently kneading, sliding or twisting. Be creative and always watch the reaction of the recipient. Stop as soon as the person has had enough or seems uncomfortable.

“REFLEXOLOGY IS FAST BECOMING AN ACCEPTED THERAPEUTIC TREATMENT.” Summer2012 | 43

MY STORY

A Reflexology Session

Hand or Foot?

The reflexologist will first take a case history (in other words, ask lots of questions!) to get an overview of their client’s health, as well as information on lifestyle and habits. Then it’s on to the foot and/or hand. The whole foot and/or hand is treated in order to treat the whole body. This makes reflexology a so-called ‘holistic’ practice. Blocked energy points can be felt by the practitioner as nodules under the skin, or the client may feel an uncomfortable point. After a treatment most people report that they feel very relaxed and ‘float’ home. Reflexologists say that even one treatment can help relieve pain, tiredness and the effects of stress, while regular treatments can help improve more serious medical conditions.

Foot reflexology is more common, but reflexology of the hand can also be completely effective. The technique is easy to master and ideal for use on oneself or loved ones. It can show immediate benefits and may be used on its own or between more comprehensive treatments by a trained practitioner. As a layperson, your efforts will constitute more of a hand massage than a reflexology treatment. However, don’t underestimate the potential benefits. For a specific health problem or condition, a consultation with a reflexologist is recommended in order to determine the safety and appropriateness of the reflexology therapy.

FURTHER READING www.reflexology-research.com Reflexology meets emotional needs International Journal of Alternative and Complementary Medicine, November 1996, pg9 – P. Trousdale

Better Health with Foot Reflexology: – D. Byers The Complete Illustrated Guide to Reflexology – I. Dougans The Complete Guide to Foot Reflexology – K. & B. Kunz

I realised how powerful reflexology is for the first time when I had a major operation. The effects of the anaesthetic left me feeling very tired, but I could not sleep as I was extremely anxious. I remembered having met a man who was a reflexologist. I called him and he came to my house. After a 40-minute treatment I felt like a new person. My anxiety had disappeared! I was not tired, just really relaxed and feeling so relieved. I have bipolar disorder and this has been very difficult to handle especially over my menopausal years. I believe that anxiety, depression and mania respond extremely well to reflexology and I feel that with on-going treatments I am more grounded and in touch with my body. This year has been hard with very real reasons to wobble and yet somehow, with weekly reflexology treatments, I am holding myself together. – SC To contact SC, email stories@thrivemag.co.za See page 5 for more info.

To Find a Reflexologist Qualified therapists are registered with The South African Reflexology Society (TSARS). www.sareflexology.org.za 021-558 9868 If the therapist has a practice number, some medical aids will pay for treatments.

Inspiration

Guesthouse This being human is a guest house. Every morning a new arrival. A joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor. Welcome and entertain them all! Even if they're a crowd of sorrows, who violently sweep your house empty of its furniture, still, treat each guest honourably. He may be clearing you out for some new delight. The dark thought, the shame, the malice, meet them at the door laughing, and invite them in. Be grateful for whoever comes, because each has been sent as a guide from beyond. ~ Rumi ~ Translated by Coleman Barks

Reprinted with kind permission Summer2012 | 45

FREE COUNSELLING Lifeline www.lifeline.org.za FAMSA www.famsa.org.za

MENTAL HEALTH PROFESSIONALS Psychiatrists www.sasop.co.za Psychologists www.psychotherapy.co.za

INFORMATION ON MENTAL ILLNESS www.sadag.org www.health24.com www.psychcentral.com www.nami.org

SUPPORT GROUPS Contact SADAG for groups in your area 011 262 6396

ONLINE FORUMS www.bipolarsa.org.za www.psychcentral.com (select community) www.nami.org (select discussion groups)

Resources & Useful Info. “because knowing where to get help is the first step to recovery …”

HELP-LINES

SADAG Suicide Crisis Line 0800 567 567 SMS 31393 8am-8pm Pharmadynamics Police and Trauma Line 0800 20 50 26 8am-8pm AstraZeneca Bipolar Line 0800 70 80 90 8am-8pm Sanofi Aventis Sleep Line 0800 753 379 8am-8pm SADAG Mental Health Line 011 262 6396 8am-8pm

Department of Social Development Substance Abuse Line 0800 12 13 14 SMS 32312 24hr helpline Dr Reddy’s Help Line 0800 21 22 23 8am-8pm Lifeline www.lifeline.org.za National 0861 322 322 AIDS 0800 012 322 Stop Gender Violence 0800 150 150

DEPRESSION CAN BE A LONELY ILLNESS

Go to www.mySupport.co.za for support and understanding.

BOOKS Depression for

Dummies Overcoming Anxiety for Dummies Bipolar for Dummies The For Dummies series offers several books on mental health. Each is jam-packed full of useful information, treatment advice and self-help techniques. Highly recommended.

GIVEAWAY Thrive has 1 copy of each book to give away. Email win@thrivemag. co.za with your full name and phone number, as well as the title of the book you would like.

67 Visagie Street, Monte Vista, 7460, South Africa Tel: +27 21 558 7252 | Fax: +27 21 558 7425 | Mobile: +27 82 584 9834

www.cognitive-behaviour-therapy.co.za

46 | Summer2012

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IN THE NEXT ISSUE …

Surviving a Manic Marriage

The Psychology of Happiness

Depression & Alcohol

Brain Basics

OBSESSIVE COMPULSIVE DISORDER: The Low-Down HOW TO: Make (small) Changes

& MUCH MORE! Summer2012 | 47

by Jessica Hewson

A man made strong by adversity

inston Churchill had a black dog. This is what he called his depression. However, he made friends with this creature and together they went on long journeys – journeys that were always adventures, but often dark and treacherous. With cigar in hand and his signature top hat, Churchill victoriously led Britain through the Second World War. As such he played a fundamental role in shaping the history of the twentieth century. Theories are coming to the fore that Churchill’s behaviour also showed elements of mania, making a diagnosis of bipolar disorder likely – and that this was instrumental in making him such a visionary and insightful leader. He was a great politician, statesman, journalist, author and painter because of his manic depression, not despite it. Churchill did not suppress his feelings, allowing himself a rich emotional life. The insights and perceptions he gained from his own journey enabled him to foresee the threat that Nazism posed to the world. John Gray, a political philosopher, observes, “He owed his foresight of the horror that was to come, to the visits of the black dog.” By 1939, Britain was coming into political awareness of its own black dog – its lack of preparation for war. Churchill’s black dog days meant he could support and guide Britain

48 | Summer2012

through this time. He did not hide his personal struggles and so provided Britain with a leader made strong by adversity and a visionary due to his wealth of emotional insight. This is demonstrated by a speech made in June 1940; “If we fail, then the whole world will sink into the abyss of a new Dark Age, made more sinister and perhaps more protracted, by the lights of perverted science”. Churchill had always dealt with his own truths. This enabled him, as Prime Minister, to deal with Britain’s truth, however grim it was at certain points; and so the nation trusted him and was inspired to act. From early on in his life, Churchill had a sense that he was destined to do great things for Britain and in his own unique style, he most definitely did so. He was passionate, volatile, irascible and eccentric. Attended by colleagues and secretaries, he would often work from his fourposter bed and frequently in the early hours of the morning. On occasion he would walk around his house naked and conduct meetings from the bathtub. Winston Churchill’s struggle with his moods heightened his leadership abilities. As historian and psychiatrist Anthony Storr wrote, “Had he been a stable and equable man, he could never have inspired the nation. In 1940, when all the odds were against Britain, a leader of sober judgment might well have concluded that we were finished.”

Why just

survive when you can

thrive with