As I reflect on the past decade, take stock of my current state, and plan ahead for the near and distant future, it’s a chance to stop and consider what has served me well to this point, bringing peace and joy into my life, and what has held me back from presenting my best, toward self and others. What is it that I need to cultivate more of, and what do I need to keep working through the process of letting go. Well, perfection, judgement and worry are just a few of the constants on the top of my list of letting go, and to be honest it’s an ongoing process. Some of what has continued to fill my life with peace and joy, are more positive relationships, more humor, more exercise and more gratitude, all of which continue to bring a degree of balance to the world around me.

For those who’ve read my last blog, I’ve already mapped out some ways to cultivate more opportunity for exercise through goal setting, and the undeniable benefits of doing so. So this next blog I’ve decided to dedicate to gratitude, something I’ve found to be a significant component in helping to achieve sustainable, connected and meaningful life goals.

The dictionary defines gratitude as “the quality of being thankful; the state of being grateful, or the readiness to show appreciation for and return kindness.” As it turns out, gratitude can be considered to be more than just a feeling and it has the potential to have a profound impact on several different aspects of a person’s well-being, including mind, body and
spirit. So, in case you’re wondering what to add to your resolution list for the new year and perhaps the decade ahead, besides more exercise of course, here are some reasons why adding an attitude of gratitude to the top of your list can be considered highly beneficial.

1. Effect on brain chemistry: Expressing gratitude and receiving the same, signals our brain to release dopamine and serotonin, the two crucial neurotransmitters responsible for making us feel good emotionally. Our mood can be enhanced immediately by even thinking about the good or positive things in our life, and by consciously practicing gratitude every day, we can help strengthen the neural pathways and ultimately create a permanent grateful and positive nature within ourselves. It creates a cycle in which the feeling you get from your recognition of good things, makes you want to think of
more good things to focus on. To use exercise as an example, try reminding yourself how much more energy you feel since fitting regular exercise into your daily routine. The brain is continuing to pump dopamine —contributing to our warm good feelings and brightening our day — all day long instead of just when exercising.

2. Effect on biological systems: Robert A. Emmons, Ph.D., a professor of psychology at University of California-Davis, author of The Little Book of Gratitude (Gaia, 2016), and a researcher who has spent decades studying the effects of gratitude reports that “clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life. It can lower blood pressure and improve immune function…” (3)

3. Effect on exercise goals: According to Emmons, clinical trials also indicate that, “… grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol, and have higher rates of medication adherence.” (3) Exercising an attitude of gratitude for even small milestones of fitness function, and focusing on what your body has done and can do vs on what it cannot yet do can go a long way toward assisting in the maintenance of your long term fitness goals.

4. Effect on mental health: By reducing the stress hormone cortisol and managing the autonomic nervous system functions, gratitude can assist in significantly reducing symptoms of depression and anxiety. At the neurochemical level, feelings of gratitude are associated with an increase in the neural modulation of the prefrontal cortex, the brain site responsible for managing negative emotions like guilt, shame, and violence. Of course, seeking professional advice from your family physician and/or a licensed clinical psychologist should be first and foremost on your agenda if you are at all concerned with the state of your mental health, however, either will then be able to offer you further guidance as to whether including a gratitude strategy into your management plan could be right for you.

5. The price: Gratitude is a simple, cheap, easy, and pleasant intervention to execute, and it is rarely contraindicated for any population. In fact, it may cost more not to try than to try, as the benefits appear to far outweigh the risks.

Beyond attitude to action: Several ways to cultivate the practice of gratitude into your life are:

Gratitude journaling- Right before bed, write down the daily top 5 of what brought joy to your day, and once a week shift that list to how you brought joy to someone else’s life throughout that week.
Consistent blessings/gifts/talents list- It’s always easy to take for granted things that come easily to us. Perhaps even basic things that others struggle to obtain or that may never be in their scope of vision.
Thanksgiving list- No one has gotten to where they are without the help of others. Making a list of people who’ve shaped your life in a positive way, and when possible letting them know, will not only make their day but yours.
Perspective shifting- Turn your mind set around and find the gift in the challenge or chore. For example, tired of picking up after everyone in your house? How about being thankful for either: a) getting in some extra squats while doing it without having to go to the gym (well, maybe that’s a stretch), or b) for having someone to share life with to pick up after (more of a stretch?), okay then perhaps c) simply for having a house to live in. It doesn’t have to be complicated. There is always something to be grateful for.

The top 5 things I am most grateful for at this moment:
1. My Faith: it’s been my constant and anchor in an ever changing world with as ever changing self, amongst ever changing others.

2. My Family/Friends: they’ve been my rock and support even when I’m not at my best; and I’ve classed them together because I feel friends really are the family you choose for yourself or in some cases who have chosen you, when you’re really lucky.

3. My Health: I appreciate all aspects of my spiritual, physical and mental health, which I’ve learned can’t be separated, or at least not sustainably so for an extended period of time, and I recognize my responsibility in taking a consistently active role in managing it

4. My Purpose: having the opportunity to contribute to a worthy cause through my professional work amongst a team of colleagues that I highly admire and respect, and through my community volunteering is a gift. Each new day is a chance to learn and to grow while at the same time assisting others to achieve their goals.

5. My Challenges/Struggles: of course I’d be lying if I said I had any desire to revisit the struggles or challenges I’ve been through over the past decade, or repeat any of the mistakes I’ve made throughout my life, however, I am content with how these experiences have shaped me. I can look back at them now as another opportunity to learn and to grow in patience, humility and compassion, in a direction of non-judgement and connectedness toward self and others.

May our 2020 VISION be focused on gratitude, and may we continue to help in building each other up in that direction.

~ Elizabeth, PT


References:
1. L.F.Cunha, L. C. Pellanda, and C. T. Reppoid (2019) Positive Psychology and Gratitude
Interventions; A Randomized Clinical Trial; Front Psychol, 10:584
2. https://positivepsychology.com/neuroscience-of-gratitude/
3. https://news.heart.org/study-gratitude-is-a-healthy-attitude/

Imagine a day where you wake up from a restless sleep. Your alarm clock startles you as you jolt out of bed and while still half asleep, you trip on your slippers that were haphazardly placed beside the bed. How are you feeling right about now? Now imagine the same scenario but instead of being jolted out of bed by your alarm clock, you are jolted out of bed due to severe, chronic back pain. How rested do you feel now? Remove the back pain scenario and imagine a migraine instead, or, an intense panic attack. You just had a restless sleep, so how much energy do you really have to start your day and face the million tasks you must complete? And how much energy does it take for you to complete each task?

For each and every one of us, our energy expenditure on daily tasks is unique to our biology and our
season of life. What may seem like an easy task or activity for one person to complete may be an
extremely difficult task for someone else to complete. But how do we compare or quantify the energy it
takes to make it through our daily activities? Enter The Spoon Theory.

The “Spoon Theory” was written by Christine Miserando. Christine lives with Lupus and the “Spoon
Theory” evolved from her attempt to communicate with her friends and family about what it is like to
live with a chronic illness. The wonderful thing about this theory is it can be applied to everyone,
regardless if you have a chronic illness or not.

When Christine’s best friend asked her what it was like to live with Lupus, she struggled to find a way to
effectively communicate the depth of the impact Lupus can have on her. Then, she grabbed a handful of
spoons, gave them to her friend and said “Here you go, you now have Lupus”. Christine explained that
the difference in having a chronic illness and being healthy is having to make choices or consciously
think about things that will use up her ‘spoons’ (or energy), when the rest of the world doesn’t always
have to. Imagine you start your day with 12 spoons. If you only had 12 spoons per day, how many
would you use to go through each stage and activity of your day? Would you complete your day with a
surplus of spoons or would you finish your day with none left at all?

For example, take one spoon away if you didn’t sleep well last night, forgot to take your medications or
skipped a meal. Take four spoons away if you have a cold. You are now left with only seven spoons to
get through the rest of your day. Now imagine you have a big presentation to give and you are
extremely nervous about it. Take one spoon away. The day is only half done and you are down to six
spoons and you still have to meet your boss for a performance review, walk the dogs in the rain and
make supper. How are you going to conserve your spoons to make it through the remainder of your
day? Now extend this theory to other people in your life. What cost you one spoon to make a
presentation may cost your spouse three spoons. Having a cold cost you four spoons but it only cost
your friend with the same cold two spoons. Can you see how we are all different and how each
experience and activity we encounter during the day affects everyone in their own unique way?

The Spoon theory allows us to quantify our physical and mental health expenditures we make to get
through a day. It is a great way to check in with yourself and with those you love.

A Living Example
In our family, we use spoons all the time. It is an effective way for me to check in with myself but also, it
helps me to understand how my son is doing. On a typical day, it usually will cost him one spoon just to
get to school every morning. He arrives at school with eleven spoons left. By noon, his mental energy is
so taxed that he has used up another six spoons. Add in a change in routine, a fire drill or unexpected
conflict with a teacher, he will often leave school with only three spoons left for the day. Now I don’t
live with ASD or ADHD, but I do live with someone who has ASD and ADHD so using spoons is very
relevant to me. Some days, it will cost me three spoons just to get him out the door to school because
he will have what I call a ‘mental spiral’ which means he has about ten things on his mind at once and to
a ‘neuro-typical’ person, those ten things can easily be filed away in the ‘to do’ pile, but to someone
with Aspbergers, they are front and center all the time until they can be dealt with. Talking him out of
his spiral and trying to create some rational goals, timelines and solutions will cost me at least three
spoons, and it isn’t even 8:00am yet. By the time my day ends, I usually fall into bed with one to two
spoons left. I fall asleep with optimism that I will get a solid rest so I can start the next day with a full set
of spoons.
​
Try using the spoon theory for yourself this next week and feel the energy expenditures you make, both
physically and mentally. Once you feel comfortable with using the spoon theory yourself, share it with
your family and friends. You will be surprised to learn how different each and every person in your life is
affected by their day to day tasks. It will help you relate better to those in your close circle and it will
extend your compassion to the rest of your community.

It is only mid week as I write this blog post and full disclosure; I AM EXHAUSTED. I wear many hats as a care provider from massage therapist, dog mom, daughter of ageing parents and what I consider the most important role, a mom to a teen who has is on the autism spectrum. The past few days sent me on a roller coaster ride from emergency room veterinary visits to emotional support for my family members who were preparing for the loss of our 11 year old bull dog. In between all of that, I still cared for our high energy foster puppy and managed to give my mother a quick ‘tune up’ massage treatment. Was my own self care sacrificed? Absolutely.  Am I ready to get back on track with self care? Most definitely.

You don’t have to have a career or profession in the health care or service industry to be a care provider. Sit back and take a look at the world around you. Who in your life are you currently supporting or providing care for because they require a little extra help, compassion and love? I bet you will come up with at least two people or one animal that you are a care provider for. At some point in our lives, we are all care providers for other people but when do we acknowledge being care providers for ourselves? What are the things we do to take care of ourselves?

There are four pillars of self-care: physical, emotional, social and spiritual. We may focus more effort on the pillars that appeal more to us, however, when we are focusing on self care, it is important to create a balance between all four pillars. This will allow you to feel truly restored and capable of caring for others because we all know that we can’t pour from an empty cup! Serving others well starts with self care.

The Four Pillars of Self Care
Physical: sleep, stretching, walking, physical release/activity, eating healthy food and rest

Emotional: stress management, forgiveness, compassion and kindness

Social: setting boundaries, knowing who your support system is, positive social relationships (in person or on social media), communication, asking for help and time with other humans/animals

Spiritual: time alone, connection to a ‘higher power’, being in nature, having a sacred space, journaling

If you look at the pillars and the associated activities, do not feel overwhelmed that you have to engage in everything. Choose one activity from each pillar to start. Perhaps you feel drawn to physical activity, showing compassion, spending time with animals and being in nature. As long as you can include one activity from each pillar, you will be better prepared to provide self care. As your self-care habits strengthen and become a regular part of your daily routine, start by adding one more activity, from one pillar at a time. Eventually, the effort you invest in self care will create positive compounding interest and you will feel the benefits extending outward to those you care for.

On a final note, self compassion is so important. If you are tired, rest. If you are sad, observe how your sadness feels. If you want time alone, take alone time. Be compassionate to the state you are and choose a healthy activity to honour that state.  Tonight I chose to book a massage for myself so I can honour my feeling of wanting to be alone and wanting something that is just for me (and because my neck is killing me from all the stress). My fatigue is more emotional and mental than physical today, so, I will also plan for a brisk walk in order to enjoy nature, fresh air and expend some physical energy with fingers crossed that no other ‘life’ distractions interrupt my ‘alone time’ . These are two self care strategies that work for me. What works best for you?

~ Michelle Smith, RMT

The past few months have brought great change.  Not only to me but to my 'group'.  There have been new jobs to be celebrated, new additions to the family, the loss of a significant member to the family, the end of the school year, new relationships, old relationships ended, new trips planned, new plans for the future.  I could go on but the point is that change is everywhere.  I think about those who have been beside me as we have been going through these changes and it makes me think about the word 'Community'.  The definition of community is

com·mu·ni·ty    /kəˈmyo͞onədē/
noun
1. a group of people living in the same place or having a particular characteristic in common.
"the scientific community"
2. a feeling of fellowship with others, as a result of sharing common attitudes, interests, and goals.
"the sense of community that organized religion can provide"
 
I grew up in a small town so to me the word community meant my actual town.  As I get older I realize that there are multiple ways to use the word 'community'.  I think for me, the most important way to use this word is when I describe the people whom have surrounded themselves around not only me but my children, my family, my grandparents and even my friends.  I used to think that the world was so big and so vast that the sense of community pertaining to the whole world was not possible.  I was wrong.  As I age I have been humbled in knowing that we are all connected in some small sort of way.  Anyone who knows me knows that this would thrill me.  I would love to be related to Ellen or Oprah or Serena or Alexandria.  OR BEYONCE (notice these are all powerful women???).  And in a way, I guess we are all are in our connection to the world. 

Relation or not, we are all living on this plane at the same time.  I am so grateful to those who have become part of my community.  I think back to growing up and unconsciously having people in my life who taught me about the responsibility of community.  I remember living on the acreage and having a giant snow storm.  We had a neighbor come over and plow out the driveway with his tractor since there was waaaaaaay more snow than what my dad's snow blower would have been able to manage.  Instead of the job taking my dad hours and hours in the freezing cold our neighbor was able to clear the snow in an hour.  A small act for him but it had a huge impact for our family that winter.  My parents no longer live on the acreage and live in Calgary.  My dad still uses the snow blower when it's needed.  He now snow blows the driveways and sidewalks for their neighbor who has had a heart attack and for an elderly couple who are physically not able to shovel.  My grandparents lived in their house on 8th and Clarence for over 50 years.  There was a widow with no children who lived on the same block as them.  As she got older my grandma started bringing her supper.  Every day.  Every supper.  For over 30 years.   

When I had my babies people would say, It takes a village to raise a child'.  I thought what a stupid comment.  But again, I realize I was wrong.  What a true statement.  Whether its teachers, coaches, your children's friend's parents, etc.  To have people who are vested in your children's lives, who want to help raise them into responsible, kind, and helpful members of society is a gift of community that makes me truly grateful.  I don't know where I would be, or my children for that matter, without those who have become a part of our community.  I think the only feeling that is better than someone helping you is being able to help someone else.  Knowing that at some point our lives will intertwine with someone who knows someone who knows someone.  I was at the airport in Calgary and had just been cleared at security.  I went to find a place to sit at my gate and sitting in front of me was Gordie Howe.  Mr. Hockey himself.  He was sitting by himself so I went and sat beside him.  I asked him if he minded that I sat beside him.  We started talking and I asked him about growing up in Saskatoon and if he remembered my grandpa since they used to play baseball together and grew up on the same street on Avenue G.  Mr. Howe told me stories about my grandpa and about the beginning of his career and leaving Saskatoon.  We took some pictures and when it was time for me to board my flight he passed along his greetings to my grandpa.  Community can connect us in ways we never thought possible.   
​
My heart is filled with gratitude when I think of all the people whose paths have crossed mine and who have become a part of my community.  For those who remind me that we have a responsibility to each other to stay connected.  To those who challenge me to do better and be better.  To those who fulfill their roles in the various communities that they are involved in.  To those whom I have been blessed with to be counted in their community.  It's not something that I take for granted or take lightly.  My life has been enriched with all of you in it.
 
Sheri
 
PS.  I will be VERY busy for the next few years celebrating the win last night

Today I was pondering what to write on.  As most of you know, I have many interests, from Women's Health, Strength and Conditioning, Acupuncture, Dry Needling, Persistent Pain Science....the list could go on.  I am also a mother, a wife, a business owner with my husband, Trevor (and trust me, people ask me how that goes!!)  So today as I was trying to plan my day, realizing the mountain of things I am seeing that I could be doing, should be doing, and figure out what needed to be done, the idea of a blog came to me.  And it came to me because a dear friend sent me an email with the words in it "You ARE enough. You ARE kind. And you've got this."

You see, on a daily basis, I see clients for various ailments and they can be effecting their quality of life - their time with their spouse, their children, their ability to do the things they love.  And today, as I'm trying to figure what to do and when to do it, I realized, these lovely clients I have the privilege of getting to help, they are taking time for themselves - or doing Self Care.  It's become a very notable word at the moment - almost trendy at times to discuss, but the reality is I have seen now, how important it truly is to take time for yourself.  Despite my clients being there, and being present for their treatment and education, I do frequently get asked, how can I take care of myself?

Recently I had the opportunity to take some time and explore the West Coast.  I headed out to Nanaimo, BC, and up to the Tofino area.  There I explored the Wild Pacific Trail, read a book, slept for 8 hours, and missed my family.  But it was a time to step back and enjoy the world around me instead of rushing through it.

Realizing this was a special circumstance, this trip to BC, it is not always how self care has to or can happen.  It can be the smallest things including:

• a cup of coffee in the morning before everyone is awake
• a short walk
• 5 mins in your office at work or home, to breath
• being in bed 30 mins earlier than normal
• reading a book
• going on a field trip with your child's class (I truly found this amazing!)
• driving in the vehicle by yourself
• being kind to yourself
• ​come up with the PRIORITY of the day rather than trying to find BALANCE
  

The list could truly go on, but I thought, after reading my email from my, I was inspired to speak to it. 

Who is this dear friend you may ask...it's Amanda of Grounded Goodness, and she knows just what to say when to say it.

I have only scratched the surface of this topic...there is so much more that could be said. But, let's have just a brief snippet sit and take it in.

Have an enjoyable weekend, and looking forward to chat with you soon.

~ Michelle, PT
​

What is mental health?

“Mental health is defined (by the World Health Organization (WHO)) as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. (1)
 
Have you ever had too many appliances in use at once and flipped a breaker?  Or perhaps you’ve opened too many windows at the same time on your laptop, only to have your system crash in the middle of an important assignment. Well, in regards to the breaker issue, you’d likely unplug all unnecessary appliances, flip the power switch back on and problem solved. As for the computer overload, you’ll probably end up closing all unnecessary windows and some programs and hit reboot. And chances are, you’ll learn from your experience and it won’t happen again...well not too soon anyway.  
 
When I think of understanding mental health these are analogies that I have found helpful to relate to. Although by comparison these are fairly simplistic analogies, since “It has been estimated that we have anywhere from 25,000 to 50,000 thoughts a day,” and “when programmed to simulate human brain activity, it took “one of the most powerful computers in the world” 40 minutes to crunch the data equivalent to just one second of brain activity.” (3)
 
So, like the overloaded electrical or computer systems, perhaps you can relate to feeling pulled in so many directions, that you suddenly felt you couldn’t keep up and found yourself experiencing difficulty coping? Anyone who knows what it feels like to suffer a great loss has likely been through a period when it feels almost impossible to journey through to the other side? Life’s stressors will always be there, and they can accumulate, a bit like “repetitive strain for the brain.”
 
When you stop and think about it, as we age and mature and experience life’s challenges, we are constantly collecting and processing vast amounts of data and assuming more numerous and complex roles with expectations for performance mounting and time always appearing to be in limited supply.  And now with the age of “high speed” technology rapidly escalating, the words “down time” seem to be becoming almost obsolete.
 
So how much is too much - your mental health limits?

• the breaking point is as varied as the number of people there are in the world, and
  
• the types of mental illness are equally as varied, because
  
• there is no one cause for mental illness, it is “A complex interplay of genetic, biological, personality and environmental factors…” (2)

 
However, though everyone is unique, what we do share in common is that we need to stop and take notice that our mental health or that of the people close to us is sending warning signs that deserve immediate attention.
 
What are some of the warning signs?

• you find yourself so worried about the future that you can’t be happy in the present
  
• you’re struggling to find the joy in things that you used to enjoy
  
• maybe you’ve started to retreat from family and friends, becoming isolated because you feel overwhelmed
  
• perhaps it takes only the smallest things to get you irritated and you find yourself struggling to control your emotions more often
  
• all the thoughts in your head are suddenly difficult to keep up with and you’re struggling with focus and with remembering
  
• you’re listening but not really hearing and find you’re having trouble carrying on a conversation

 
If you can identify with any of these warning signs on a consistent basis, It’s likely your brain and your body are signalling you that your mental health is requiring attention.  Awareness is key, knowledge is power.
 
What do you do if you or someone you know has reached or is on the way to reaching their limit?
When your system starts giving you signs that you’ve reached or are about to reach your breaking point, “Mental illnesses can be treated effectively.” (2) With increasing awareness and many resources now available to address this issue you need not struggle alone.

• See your family physician or health care provider- they can help advise in regards to the best course of action to initiate your recovery process and ongoing management
  
• Seek a referral to a counsellor- they are trained professionals whose main goal is your mental health wellness and they possess a wealth of knowledge and an endless amount of resources to help you
  
• Talk to your spiritual advisor, a trusted family member or a close friend, a compassionate ear is often the first step in a successful recovery
  
• Maintain a healthy diet, remembering that what you put into your body is fuel for your brain
  
• Take advantage of the benefits of regular physical activity, provided your doctor has cleared you for any contraindicating physical health issues, remembering that realistic goals are best
  
• Get the appropriate rest you need, in order to regenerate and restore your mind - unplugging from technology on a regular basis’ and keeping the bedroom for sleep are some helpful tips
  
• Increase your awareness of your own mental health, becoming mindful of what goes into your mind, how much you hold on to, and what may be necessary to let go of
  
• The practice of mindfulness and other relaxation or meditation techniques are helpful tools that have recently been proven to be very effective  

 
Who is affected by mental health - are you at risk?

• In any given year, 1 in 5 people in Canada will personally experience a mental health issue (2)
  
• Mental illness affects people of all ages, education, income levels, and cultures. (2)
  
• By age 40, about 50% of the population will have or have had a mental illness (2)

 
So chances are high that we or someone close to us will be affected by a mental health crisis or illness at some point in our life.
 
How can we reduce the likelihood of getting to this point before recognizing it and seeking help? 
Take ownership – empower yourself, and empower others.  In my personal experience, dealing with big life changes has never been easy, but up to this point I’d like to think I’ve managed ok.  But as I’ve gotten older, accepting these changes has become even more difficult, even though I realize that they are a necessary part of life.  Hopefully it won’t take you a multiple succession of changes and maxing out on coping strategies before you realize that it’s ok for a caregiver to take a break and receive care. There is no shame in asking for help, as shame invokes fear and fear in turn defeats growth. Instead, realize that even the tiniest of steps forward can make all the difference and aim for continued progress with obtainable goals, not perfection. No one is perfect. Be courageous.  We can all think of something we want to change but are we willing to be that changing factor, putting fear aside and becoming a catalyst for others to follow suit. Surround yourself with positive influences that are willing to walk beside you on your mental health recovery journey, who are willing to help you draw out your full potential once again. Then pay it forward and walk beside someone you know as they journey through as well.  Though our issues may differ we are all in this together. There is strength in numbers.

Where will I stand going forward?                                                                                        
Plan to attend Cameco’s Step up for Mental Health initiative, where exercise, awareness and community support meet to make a difference May 11, 2019. https://www.stepupformentalhealth.ca/step-up-program/what-is-step-up

Sign up for a mental health first aid training course and empower yourself by increasing your own knowledge about mental health. https://saskatoon.cmha.ca/programs-services/mental-health-first-aid-training/

~ Elizabeth, PT


References:
(1) https://www.who.int/features/factfiles/mental_health/en/
(2) https://cmha.ca/about-cmha/fast-facts-about-mental-illness
(3) https://www.psychologytoday.com/us/articles/200107/depression-doing-the-thinking