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Alive Integrative Medicine
  • Home
  • MEET US
    • Brielle Mele, ND
    • Nathaniel Bingham, ND
    • Kendall Smith, ND
    • Brooke Bodeen, ND
    • Claudia Knight, DO
    • Dusty Bodeen, LMT, LAc, MAcOM
    • Cezanne Bauer, LMT
  • FAQs
  • Clinic Info
    • Our Mission & Values
    • Our Policies
  • Schedule Online
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  • REFERRALS
  • Resources

What is Integrative Care?

4/3/2019

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"Integrative Healthcare is an approach to care that seeks to integrate the best of Western scientific medicine with a broader understanding of the nature of illness, healing, and wellness. Easily incorporated by all medical specialties and professional disciplines, and by all health care systems, its use not only improves care for patients, it also enhances the cost-effectiveness of health care delivery for providers and payors.

A practical strategy, integrative medicine puts the patient at the center of the care and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health. Treating the whole person addresses both the patient’s immediate needs as well as the effects of the long-term and complex interplay between a range of biological, behavioral, psychosocial and environmental influences are addressed. This process enhances the ability of individuals to not only get well, but most importantly, to stay well.

Integrative medicine seeks to restore and maintain health and wellness across a person’s lifespan by understanding the patient’s unique set of circumstances and addressing the full range of health. Through personalizing care, integrative medicine goes beyond the treatment of symptoms to address all the causes of an illness. In doing so, the patient’s immediate health needs as well as the effects of the long-term and complex interplay between biological, behavioral, psychosocial and environmental influences are taken into account."

Alive Integrative Medicine's model of integrative care emphasizes the client's control of experience. Before any discussion involving client information between clinicians occurs, the client is given the option to consent to integrative treatment. If the client wishes for clinicians to operate independently, then their patient information remains confidential to each clinician, respectively.  However, if the client agrees to integrative care, then they remain fully informed of all communications between clinicians. Clinicians and patient will continue operating as a team to develop the best integrative healthcare plan that makes you feel most alive! 


Resources: 
What is Integrative Medicine? (n.d.). Retrieved  from https://www.dukeintegrativemedicine.org/about/what-is-integrative-medicine/
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TMC - Cupping

3/13/2019

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With growing popularity, the general public has started asking more questions about Traditional Chinese Medicine (TCM). Acupuncture alone has become a widely accepted and a formidable therapy, especially for pain management. Many physicians are referring patients for acupuncture and hospitals have even started creating integrative care models within hospital settings that include therapies like acupuncture and massage. While you may have heard of acupuncture, it is only one part of the TCM model. Other modalities of TCM include: Chinese herbal therapy, internal martial arts (both static and moving exercises known as Taiqi and Qigong), Chinese nutritional therapy, Asian Bodywork Therapies/ABT (Shiatsu and Tuina), moxibustion, e-stim, and cupping.

Thanks to popular culture another branch of the TCM model is now trending - cupping. Early trendsetter Gwyneth Paltrow brought cupping to the red carpet in 2004, Michael Phelps brought cupping to the summer Olympics in 2016, and more recently Kim Kardashian Snapchatted about facial cupping in March 2017. However, cupping has been used in China for thousands of years. In fact, some of the earliest records of cupping can be dated back to the second century BC with the discovery of the Huang-Lao Boshu texts, five ancient manuscripts written on silk scrolls. These manuscripts were written to advise the authorities of the ruling Han dynasty on how to attune themselves to the cosmos at a time of rapidly changing social and political climate (Rochat de la Vallée, n.d.). Ge Hong (283-343 AD), a Taoist physician, alchemist, and herbalist wrote the Handbook of Prescriptions for Emergencies which documented effective uses for cupping, though it was most well known for its key insights on the treatment of malaria. In his descriptions, he elaborates on the use of animal horns as cups (a technique known as jiaofa), which he used to treat skin lesions. “Several centuries later another famous medical classic, Su Sen Liang Fang, recorded an effective cure for chronic cough and the successful treatment of poisonous snakebite using cupping therapy” (Upton, 2018). Eventually, in the 1950s, cupping was established as an official therapeutic practice used in hospitals across China after research was conducted by China and former Soviet Union acupuncturists confirming cupping’s effectiveness. 

Early understanding and applications of cupping held that illness and infection could literally be drawn out of the body through the skin. Ancient techniques often included wet cupping, using cups made from segmented bamboo or cattle horn to draw blood from the body. A partial vacuum was created by the heating and subsequent cooling of the air inside the horn. This vacuum then drew out the pathogenic factors. Several thousand years of accumulated clinical experience has since given way to a wide range of clinical applications. Current classifications are as follows: 
  • Dry cupping - cupping over unbroken skin
  • Wet cupping - blood which is drawn out of small incision
  • Flash cupping - cups that are quickly placed and instantly removed, then repeated over different areas
  • Stationary cupping - cups placed over specific acupuncture points
  • Sliding cupping - cups gliding with or against a chosen meridian
  • Herbal cupping - cups soaked in Chinese herbal concoctions prior to placement and/or herbal liquids that are retained inside the cups
Some practitioners also consider different levels of vacuum (soft, moderate, or strong suction), as well as graded temperatures. 

TCM theory asserts that cupping stimulates the opening of the pores, disperses stagnant qi and blood, and eliminates external pathogenic factors such as wind, damp, heat, and cold. It is therefore regarded as a reducing method to relieve the body of excess - blockages, toxins and impurities. However, in some cases a well trained practitioner can use soft, flash cupping as a tonifying method for deficiency type syndromes, such as skin numbness, flaccidity, or hypo-function. Clinical indications of cupping can include the treatment of “Bi” (syndrome caused by wind-dampness which manifests as pain in the lower back, shoulders, and legs), gastrointestinal disorders (stomach ache, vomiting, and diarrhea), and lung diseases (cough and asthma). Cupping combined with blood-letting is still suitable for the treatment of sprains and other soft tissue injuries with blood stasis (Lin, Wang, & Ng, p. 3). 

After a successful treatment you will see petechiae, or what TCM calls “sha” (literally means sand, or sediment, in reference to its appearance), or “yinzi” (marks). Petechiae consists of red or purple lesions that are similar to bruises, in that they result in the leakage of blood from the vessels into the tissues. However, petechiae is not the result of blunt force trauma, which is always the case with bruising. “According to every cupping tradition, the marks are always the result of certain pathological agents being released from deep within the body, or from the superficial level including the subcutaneous skin layers and the fascia. Thinking of cupping marks as bruises may conjure up the notion that they must be the result of a painful procedure. On the contrary, cupping performed correctly, with the appropriate choice of method and the correct level of suction to suit the patient’s strength and condition, is always a comfortable and satisfying experience” (Bentley, p. 2-3).

The basic principles, applications, and indications of cupping remain the same as were originally practiced in ancient China. However, the use of animal horns and bamboo have been replaced with cups made of glass, plastic, and silicone. Silicon cups are most commonly used today by licensed acupuncturists and other qualified healthcare practitioners, such as chiropractors, physical therapists, and licensed massage therapists. This is likely due to their affordability, flexibility, durability, and ease of movement. They can also be applied using mechanical pumps or simply squeezing and pressing the cups to the skin without the use of heat. 

Although cups are extremely safe to use and can even be self-applied, certain precautions should be considered. Cups should be applied in areas where muscles are abundant with few hairs and where there is no prominence or depression of the bones. Contraindications include skin ulcers, inflamed skin, tumors, scars, varicose veins, hypersensitive skin, sensory organs, large blood vessels, the apex of the heart, the lumbosacral and abdominal regions of pregnant women, convulsive disorders, cancer, and diseases with hemorrhagic tendencies (Lin et al., 2018, p. 5). Caution should also be used with children and seniors. 

If the concepts behind TCM cupping seem too antiquated, it might help to imagine the use of cups as an inverse massage. Rather than applying pressure to muscles, cups use gentle pressure to pull the muscles upward, easing areas of congestion, relieving muscle tension and fascial adhesions, sedating the nervous system, and encouraging circulation and detoxification. Despite the fact that cupping is not exclusive to TCM, it is generally combined with an acupuncture treatment during the last 10-15 minutes, with cupping marks resolving in three days to one week. Given the many benefits of this adjunctive therapy, it’s no wonder why cupping is all the rage. 

Resources:
  1. Bentley, B. (2013). A Cupping Mark Is Not A Bruise. The Lantern Journal of Traditional Chinese Medicine, 12(2), pp. 2-3. Retrieved from https://www.healthtraditions.com.au/essays/a-cupping-mark-is-not-a-bruise.pdf
  2. Lin, X, Wong, H.F., & Ng, S.C. (2018). Cupping, the Past and Present Application. Chinese Medicine and Culture, 1(3), pp. 3-5. doi: 10.4103/CMAC.CMAC_37_18.
  3. Rochat de la Vallee, E. (n.d.). The Texts of Ma Huang Dui [Web log post]. Retrieved from www.elisabeth-rochat.com/texts/Ma_Wang_Dui.html
  4. Upton, E. (2018). Alternative Medicine In Under An Hour: Easy-To-Follow Guide To Sorting Out Holistic Medicine, Ch. 3. Beverly Hills, CA: Fifth Element Press. Kindle file.
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​Shoveling snow: workout or throw-your-back-out?

2/28/2019

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Shoveling snow can be a great work out, but it can also put you at risk for injury. Check out these tips before going out to move that heavy snow and ice that covers the Eugene area.

Do a Proper Warm-Up
If you just woke up, wait 45 minutes to an hour before shoveling. But before you shovel at any point in the day, move through a quick dynamic warm-up to "wake up" all the right muscles, says Lovitt. "A great warm-up people can do is knee grabs—standing and pulling each knee to your chest alternating—for 12 to 15 reps on each side and large arm circles forward and back for a few reps," she says.
Dr. Lawless also suggests getting your heart pumping by walking at 2.5 miles per hour on the treadmill for one mile before you head outside.

Fire Up the Right Muscles
"When you think about the biomechanics of shoveling snow, the biggest challenge of the movement is taken on by the muscles and joints of the back of the body," explains Cris Dobrosielski, a certified strength and conditioning specialist and spokesperson for the American Council on Exercise. The neck, shoulders, and low back in particular get pulled forward as you drive the shovel into the snow, and they have to work together to stabilize your body. "It's really a form of resistance training," Dobrosielski says.
Just before you lift a shovel full of snow, think about two main things: keeping your knees slightly bent at all times, which  takes some of the tension off of the low back, and hinging at the hips. "Draw in the navel slightly, keep your back straight and abdominals engaged, and shift your hips back slightly, which will help turn on the glutes and hamstrings, where most of the power should come from," Dobrosielski explains. "Then brace your body from this position while you drive the shovel into the snow and lift and throw."
While you're in this position, you want to remind yourself to constantly keep your core engaged, Lovitt adds. "Brace your midsection as if you were going to take a punch to the stomach."


Hold the Shovel Correctly
Keep a wide grip on the shovel handle—with one hand near the top of the handle and the other close to the actual shovel full of snow—so that you have better control of the heavy load. Also, keep the shovel as close to your body as possible as you carry it.
"You have a mechanical advantage when you keep the lever arm of the shovel and the weight of the load close to your body," Dobrosielski says. "The closer the load is to your center of gravity, the less strain and discomfort you are putting on every muscle and joint involved in that movement."


Don't Twist and Throw
What does bad form look like? To start, you shouldn't be rounding your shoulders and dropping your back to lift the snow without engaging your legs and glutes—or using your lower back to lift the snow in the shovel (but you know that now). But another huge mistake is twisting or hyperextending your back to propel and throw the snow off the shovel.
"You may need to twist your torso a little bit to maneuver the snow, but you should really be thinking about turning your entire body with the shovel in the direction that you want to drop the snow and gently tip the shovel for the snow to drop off," Dobrosielski explains. "You shouldn't have to twist a lot, and you should never be throwing snow from the shovel up by your shoulders. The shovel can stay at or below your waist."
And when you can, don't even lift the snow; just plow it to the side.


Take Breaks
"When fatigue sets in, this is when injuries tend to happen," Lovitt cautions. So keep your snow-shoveling intervals short and sweet, taking breaks whenever you need to.
"I wouldn't suggest going outside for more than 40 minutes at a time," Dobrosielski says. "And I would break that up until two 20-minute periods for fit people, and even four 10-minute intervals for more sedentary people."
Another tip: Keep the scoops small. "You may think it makes more sense to scoop these huge heavy piles to move more snow more quickly, but this will tire most people out faster than just doing more reps with little piles," he adds.


Make Shoveling Snow a Workout 
If you're shoveling snow properly, you'll work your glutes, hamstrings, quads, abs, low back, upper back, and shoulders. "It's the absolute best workout," Lovitt says. Once you get into the swing of things and nail your form, you can really start to make it a double-duty chore and up the fitness factor. 
"Do lunges or squats into each shovel of snow," Lovitt says. You can also carry the piles of snow farther down the driveway to get extra steps in if you're feeling ambitious.
One caveat: If you're recovering from a heart attack or have known risk factors for cardiovascular disease, do not shovel snow without clearance from your doctor.

If you are feeling the effects of snow shoveling or suffered a fall, be sure to reach out for an evaluation and treatment. We're here to help you feel and move your best!

Resources:
​Andriakos, J. (2018, February 6). 7 Tips to Shovel Snow Safely and Efficiently (and Even Turn It Into a Workout). Retrieved February 28, 2019, from https://www.health.com/fitness/right-way-shovel-snow


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Naturopathic Medicine - Frequent Questions

2/20/2019

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1. What is Naturopathic Medicine? 
Naturopathic medicine is a distinct practice of medicine that emphasizes prevention and the self-healing process to treat each person holistically and improve outcomes while lowering health care costs.
  • Naturopathic doctors are educated and trained in accredited naturopathic medical colleges. They diagnose, prevent and treat acute and chronic illness, restore and establish optimal health by supporting the person's inherent self-healing process. Rather than just suppressing symptoms, naturopathic doctors work to identify underlying causes of illness, and develop personalized treatment plans to address them. Their Therapeutic Order™, identifies the natural order in which all therapies should be applied to provide the greatest benefit with the least potential for damage.
  • Remove Obstacles to Health. Health, the “natural state” of one’s body, is disturbed by obstacles that lead to disease. The first step in returning to health is to remove the entities that disturb health such as: poor diet, digestive disturbances, inappropriate and chronic stress levels, and individual disharmony. Naturopathic doctors construct a healthy regimen based on an individual’s “obstacles to health” to change and improve the terrain in which the disease developed. This allows additional therapeutics to have the most beneficial effects possible.
  • Stimulate the Self-Healing Mechanisms. NDs use therapies to stimulate and strengthen the body’s innate self-healing and curative abilities. These therapies include modalities such as clinical nutrition, botanical medicines, constitutional hydrotherapy, homeopathy, and acupuncture.
  • Strengthen Weakened Systems. Systems that need repair are addressed at this level of healing. Naturopathic doctors have an arsenal of therapeutics available to enhance specific tissues, organs or systems including: lifestyle interventions, dietary modifications, botanical medicine, orthomolecular therapy (use of substances that occur naturally in the body such as vitamins, amino acids, minerals), and homeopathy.
  • Correct Structural Integrity. Physical modalities such as spinal manipulation, massage therapy, and craniosacral therapy are used to improve and maintain skeletal and musculature integrity.
  • Use Natural Substances to Restore and Regenerate. Naturopathic medicine’s primary objective is to restore health, not to treat pathology. However, when a specific pathology must be addressed, NDs employ safe, effective, natural substances that do not add toxicity or additionally burden the already distressed body.
  • Use Pharmacologic Substances to Halt Progressive Pathology. NDs are trained in pharmacology and how to use pharmaceutical drugs when necessary. If their state license permits, they can prescribe these agents themselves or if not, refer to a conventional medical colleague.
  • Use High Force, Invasive Modalities: Surgery, Radiation, Chemotherapy. When life, limb, or function must be preserved, NDs refer patients to MDs who are expertly trained in these arenas. At the same time, NDs use complementary or supportive therapies to decrease side effects and increase the effectiveness of these invasive procedures.

2. Under what circumstances should I choose to see a Naturopathic Physician?
  • You want a doctor who will treat all of you, not just your illness.
Naturopathic doctors (NDs) are trained to treat the whole person. This requires taking the time to listen and understand the genetic, environmental, and behavioral/lifestyle factors that can affect your health. At your initial appointment, you’ll spend up to an hour or more talking with your ND.
  • You want personalized treatment.
NDs understand there is no one-size-fits-all treatment that works for everybody. After your visit with an ND, you’ll leave the doctor’s office with a treatment plan uniquely tailored to you, your health status, your health goals, and your lifestyle. 
  • You want to treat the root cause of an illness, not just the symptoms.
Sometimes having trouble sleeping, aches and pains, strange or hard to treat skin rashes, and indigestion or stomach discomfort are symptoms of an underlying illness. While these symptoms can be managed, it’s more important to understand and treat the root cause—which is the focus of naturopathic medicine.
  • You want to actively participate in managing your own health.
An ND will help you learn what your body needs to get well and stay healthy. Patients have the opportunity to feel empowered and hopeful when they understand and are actively engaged in managing their own health.
  • You have chronic pain and don’t want to use pharmaceutical drugs such as ibuprofen, acetaminophen, or highly addictive opioids to manage it forever.
Pain that lasts six months or more is more complex than acute pain and requires a holistic, long-term approach to manage. NDs are trained to work with you to determine which combination of therapies will work best for you to heal or manage your pain safely so that you can resume daily activities.
  • You have tried all conventional medical options for diagnosing and treating a health condition.
Certain chronic health conditions that have symptoms such as fatigue, insomnia, or gastrointestinal distress can be difficult to diagnose and treat, and can benefit from a holistic approach. NDs use diagnostic tools common in conventional medicine, such as detailed health, disease, and prescription drug histories, physical exams, and targeted laboratory testing and imaging. NDs also consider detailed diet history, lifestyle habits and choices, exercise history, and social/emotional factors to assess patients’ needs. These approaches can open doors to new treatment pathways and options.

3. What do Naturopathic Physicians mean by "treating the whole person"?

Naturopathic doctors (NDs) follow six guiding principles that serve as a philosophical platform for all of naturopathic medicine. The principles influence how NDs think about medicine, make clinical decisions, and most importantly, how you are treated as a patient. Treat the whole person is one of these six core principles.
Multiple factors contribute to your health, including: diet, lifestyle, genetics, psycho-emotional make up, spirituality, socioeconomic position, environmental issues, and more. While most primary care providers are trained to treat the body, few also address matters of the mind and spirit, elements that are equally important. Licensed naturopathic doctors are trained to uncover, evaluate, and address relevant obstacles to healing. They take extra time with patients and provide highly individualized care.
Guided by the Therapeutic Order, naturopathic doctors focus on identifying the underlying cause(s) of your health concerns and empowering you to engage actively in restoring and managing your own health. Research shows that whole-person care often leads to higher patient satisfaction and improved outcomes.

All information was pulled from the American Association for Naturopathic Physicians (AANP). For additional questions, please see the AANP FAQs page linked to the image below. 
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Lowering inflammation with a plant-based diet

2/1/2019

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In the progression of atherosclerosis, inflammation is a major factor which can influence adverse cardiovascular events.  Treatment regimens to reduce inflammation and hsCRP (high sensitivity C-reactive protein) have shown to reduce coronary artery disease (CAD) and poor cardiovascular events.  One third of patients with known CAD have an elevated hsCRP. The American Heart Association (AHA) diet (Heart Healthy Diet) is designed to reduce the risk and advancement of CAD and hsCRP, however, multiple dietary factors influence CAD.  45% of patients with known stable CAD and who are being treated with the standard of care including diet and lifestyle modification will continue to have elevated hsCRP. 
 
A plant-based vegan diet has been shown to significantly reduce adverse markers of poor cardiovascular health over time, but limited comparisons with other heart-healthy diets remain.  A recent study of 100 participants was published in The Journal of the American Heart Association (JAHA) and directly compared the effects of a vegan versus AHA-recommended diet on hsCRP, as well as other markers of inflammation, glucometabolic markers, and lipid profiles in patients with established CAD on guideline-directed medical therapy.
 
The trial demonstrated a significantly greater reduction in hsCRP with a vegan vs. AHA-recommended diet. There was a 28% reduction in hsCRP with a vegan diet versus a 7% with an AHA recommended diet. Weight loss measures by body mass index (BMI) and waist circumference did not significantly differ between the two diet groups.  Markers of glycemic control and lipid profiles, overall, did not differ greatly. 
 
A vegan diet has significantly higher amount of dietary fiber and studies have shown that a diet high in fiber and low in fat is associated with less inflammation and lower incidence of major cardiovascular outcomes.  The anti-inflammatory effect of fiber is well established, but the underlying mechanism remains unclear, and data suggests increased fiber intake may restore gut microbiota, which may in turn, improve the inflammatory profile.
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How do I know if i need therapy?

1/15/2019

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Most of us face struggles at some point in our lives. These struggles may include stress at work, difficulty with a romantic partner, or problems with a family member. Alternatively, struggles may include emotional symptoms such as depression or anxiety, behavioral problems such as having difficulty throwing useless items away or drinking alcohol too often, and cognitive symptoms such as repetitive upsetting thoughts or uncontrolled worry. Sometimes, life's struggles can be eased by taking better care of yourself, and perhaps talking about the issues with a supportive friend or family member.
But there may be times when these steps don't resolve the issue. When this happens, it makes sense to consider seeking the help of a qualified licensed counselor or therapist. How do you know if therapy is needed?
Two general guidelines can be helpful when considering whether you or someone you love could benefit from therapy. First, is the problem distressing for the person experiencing it? And second, is it interfering with some aspect of life?
When thinking about distress, here are some issues to consider:
  • Do you or someone close to you spend some amount of time every week thinking about the problem?
  • Is the problem embarrassing, to the point that you want to hide from others?
  • Over the past few months, has the problem reduced your quality of life?
When thinking about interference, some other issues may deserve consideration:
  • Does the problem take up considerable time (e.g., more than an hour per day)?
  • Have you curtailed your work or educational ambitions because of the problem?
  • Are you rearranging your lifestyle to accommodate the problem?
A “yes” response to any of these questions suggests that you might wish to consider seeking professional guidance. Remember that sometimes a problem might be less upsetting to you than it is to the people around you. This does not automatically mean that you are in the know and your friends or family are over-reacting to you. Rather, this situation suggests that you may wish to think about why the people who care about you are upset.
Certainly, the decision to enter into therapy is a very personal one. Numerous advances have been made in the treatment of psychological disorders in the past decade and many therapies have been shown scientifically to be helpful. As you think about whether therapy might be helpful to you, remember that many psychological problems have been shown to be treatable using short-term therapy approaches.
Learning more about different approaches to therapy might also help you to discern if one of them sounds like a good fit with your personality and approach to life. Given the range of therapeutic options that are available, you don't need to continue to struggle with a problem that is upsetting and/or getting in the way of other parts of your life. Help is available.
Ariel Yabek LMFT, and Emily Snodgrass LPC-Intern, conduct holistic integrative psychotherapy. Ariel's practice is currently full with a waitlist and Emily has immediate availability. For further information, please review their respective professional pages on this website for more information. Or call us at 541-636-3079 to schedule your initial session. 
Source: APA Div. 12 (Society of Clinical Psychology
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skeleton Health - Mobility + Stability

12/28/2018

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Mobility vs Stability: 
Some people have had experiences with chiropractic where they are adjusted along the entire spine regardless the cause of their discomfort or injury. I try to be very specific and only adjust the segments of your spine that actually need more movement. In order to move optimally, we need to balance strength and stability with mobility and movement of the joint or joints.
As a generalization, different regions of the body are more prone to needing stability OR mobility and they tend to alternate. For example, your thoracic spine (where your rib cage is) and pelvis (usually need) more mobility or movement at the joint segments, while your neck and low back need more stability. When someone doesn’t have a lot of mobility in their thoracic spine, the neck and the low back try to make up for it and end up moving much more than they should. So, we can help you increase the mobility in the areas that need it, AND help you to strengthen and coordinate the activation of muscles that need to be more active in stabilizing the joints.
This works similarly in the extremities. For example, many people with knee pain, have decreased mobility in the hips and ankles, and their knee is moving too much or possibly in a less than ideal direction. Of course, this is a generalization. Based on your history or prior injuries your case may be different. This is why we do a thorough exam so that we can determine what YOU need and then we can plan treatment accordingly. If you have a trouble area, give us a call or book online. We love to help you feel your best!
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Seasonal Affective disorder (SAD)

12/10/2018

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Seasonal Affective Disorder 
What is it? 
Seasonal Affective Disorder is a type of depression that’s related to the changing of the seasons. SAD begins and ends about the same time every year. If you're like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. Less often, SAD causes depression in the spring or early summer. This depression diagnosis is different from other depression disorders because it is only present during one time of the year, either summer or winter months. 

Symptoms
In most cases, SAD symptoms begin to appear in the late fall or early winter months and last until the sunnier days of the spring and summer. In individuals with the opposite pattern, they may experience symptoms beginning in the spring and summer months and end towards the darker winter days. In both cases, symptoms may begin as mild but progressively worsen as the seasons progress. 

Symptoms of SAD, upon seasonal onset, may include:
  • Feeling depressed most of the day, nearly every day
  • Losing interest in activities you once enjoyed
  • Having low energy
  • Having problems with sleeping
  • Experiencing changes in your appetite or weight
  • Feeling sluggish or agitated
  • Having difficulty concentrating
  • Feeling hopeless, worthless or guilty
  • Having frequent thoughts of death or suicide

Fall and Winter SAD
Symptoms that are specific to winter-onset SAD may include: 
  • Oversleeping
  • Appetite changes, especially a craving for food high in carbohydrates
  • Weight gain
  • Tiredness or low energy

Spring and summer SAD
Symptoms that are specific to summer-onset SAD may include: 
  • Trouble sleeping (insomnia)
  • Poor Appetite
  • Weight loss
  • Agitation or anxiety
  • Anger mood swings

Cause and Effect 
What causes SAD will be different for every individual. Some risk factors that could make one more susceptible to SAD are: family history of depression or SAD, having a major depressive disorder or bi-polar disorder, and chances of SAD increase the farther away from the equator you live. 
In addition to these risk factors, other possible causes of SAD have been found. Other factors include: the individuals circadian rhythm (one’s biological clock) disrupted by lack of sunlight, a decrease in serotonin (a brain neurotransmitter that affects mood) by lack of sunlight, and lastly melatonin levels are affected which regulate your sleep patterns and mood. No specific cause of SAD has been found, but these factors play a contributing role with the onset of symptoms. 
It is important to take signs and symptoms of SAD seriously. Just as other types of depression worsen with time, so does seasonal affective disorder. Many of these behavioral implications are harmful to the individuals everyday life functioning. Affected life areas may include: social withdraw, school or work problems, abnormal emotion outbursts, substance abuse, suicidal thoughts or behaviors, and other mental health disorders like anxiety and eating disorders. 

Treatment
It's normal to have some days when you feel down. But if you feel down for days at a time and you can't get motivated to do activities you normally enjoy, see your doctor, counselor, or psychotherapist. This is especially important if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, or you feel hopeless or think about suicide. 
Don’t brush off that yearly feeling simply as a case of the “winter blues” or a seasonal funk that you have to tough out on your own. Treatment for SAD may include psychotherapy, medications or supplements, and light therapy (phototherapy), mind-body connection, alternative medicines, and with mind cases, home remedies are helpful. 

Coping and Support
These are the steps one can take to manage their SAD symptoms:
  • Stick to your treatment plan - attend therapy and take supplements as planned
  • Take care of yourself - this means proper eating, sleeping, exercise, and hygiene
  • Practice stress management - use techniques mastered in therapy or found elsewhere
  • Socialize - it is easy to isolate oneself, but getting out and being social is proven to help stabilize mood


Information sourced from DSM-5 and Mayo Clinic’s SAD treatment and diagnosis page


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Hegu Acupuncture point

11/14/2018

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POINT: LI 4

PINYIN NAME: Hegu
ENGLISH TRANSLATION: Joining Valley
CHANNEL: Large Intestine (LI)
YANGMING CHANNELS: LI and Stomach (ST) - abundant in Qi and Blood

COMMAND POINT: LI 4 is the single most important point to treat disorders of the face and sense organs.
FOUR GATES (point combination): LI 4 + LV 3. Used to treat painful obstruction.

FUN FACT: Commonly used point in acupuncture analgesia.

ACTIONS
  • Regulates defensive qi (Wei Qi) and adjusts sweating/pores (whatever the pattern)
  • Expels wind and releases the exterior 
  • Treats all diseases of the head, face, ears, eyes, nose, cheeks, mouth and teeth - whether acute or chronic, hot or cold, deficient or excess.
  • Activates the channel and alleviates pain (According to Chinese medicine, pain of excess type arises when impaired circulation of qi and blood leads to stagnation.)
  • Induces labor
  • Restores the Yang - can revive consciousness.

INDICATIONS
  • Exterior wind-cold patterns, chills and fever, injury by cold with great thirst, copious sweating, absence of sweating, febrile disease with absence of sweating, floating pulse.
  • Headache in any location due to attack by exterior pathogens, and most particularly any frontal (yangming channel) headache, one-sided or generalized headache.
  • Redness, swelling and pain of the eyes, dimness of vision, superficial visual obstruction.
  • Nosebleed, nasal congestion and discharge, rhinitis, sneezing.
  • Toothache or pain of tooth decay in the lower jaw, mouth ulcers.
  • Throat pain, loss of voice
  • Swelling of the face, deviation of the face and mouth, lockjaw, deafness, tinnitus.
  • Amenorrhea, prolonged labor, delayed labor, retention of the placenta.
  • Constipation (due to channel obstruction)
  • Painful obstruction, pain of the sinews and bones, pain of the arm, contraction of the fingers, pain of the lumbar spine; can treat a variety of disorders involving pain and spasms.
CONTRAINDICATION
  • Pregnancy

INSTRUCTIONS: Apply acupressure for up to 1 minute, two times daily or as needed.

Information sourced from Peter Deadman, ​A Manual Of Acupuncture 
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Relational Therapy

10/29/2018

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Ariel Yabek is a Licensed Marriage and Family Therapist with over 13 years clinical experience. Ariel is trained in Relational Culture therapy, a theoretical model that explores the conditions that support the development and maintenance of mutually beneficial  and sustainable relationships. As an Integrative and Relational therapist, Ariel collaborates with clients to identify and cultivate resources, supports and protective factors so they may feel increasingly more empowered in their life. Ariel incorporates mindfulness practice as well as cutting edge research in the field of Interpersonal Neurobiology (Daniel Siegel). Ariel is deeply anchored in the values of courage, safety and dignity for all people and view’s clients from a contextual and ever-changing perspective.  Ariel strives to encourage therapeutic work that is respectful, honest and meaningful.
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Blog from Psychology Today: Relational Therapy

Relational Therapy​
What Is Relational Therapy? Relational therapy, sometimes referred to as relational-cultural therapy, is a therapeutic approach based on the idea that mutually satisfying relationships with others are necessary for one’s emotional well-being. This type of  psychotherapy takes into account social factors, such as race, class, culture, and gender, and examines the power struggles and other issues that develop as a result of these factors, as well as how they relate to the relationships in a person’s life.

When It's Used
People who are experiencing distress from their family, intimate, professional, or social relationships may benefit from relational therapy. This includes those who are experiencing mood disorders, such as anxiety, depression, or stress, that are causing relationship issues and those who suffer from low self-esteem, eating disorders, and poor body image. 

What to Expect
In relational therapy, you learn to identify how you may be pushing people away rather than attracting them and also come to understand how these behaviors are related to past experiences. The goal is to develop new ideas about relationships, to build a strong relationship with the therapist, and to use both those new ideas and the therapeutic relationship as a model to create healthier, longer-lasting relationships with others.

How It works
Relational therapy stems from relational-cultural theory and the work of Jean Baker Miller in the 1970s and ‘80s, that looked at human connection and the ways culture influences relationships. Miller’s work centered on women, privilege, and power, and the dominant and subordinate roles played out in relationships. At that time, there was a movement in the field of psychotherapy away from pure introspection and toward an exploration of the dynamics of human relationships and their effects on individuals. More focus was given to emotional issues, stress, and power differentials from past relationships and how they can interfere with true personal expression and the ability to form solid relationships in the present. Relational-cultural theory focuses therapists and counselors on the cultures and contexts that affect relationships so they can work effectively with more diverse clients. The therapist addresses these issues within the context of the therapeutic relationship and the client’s relationships outside of therapy.

What to Look for in a Relational Therapist
Look for a licensed, experienced mental health professional with specific training in relational cultural theory or relational therapy. In addition to finding someone with the appropriate educational background, experience, and relational approach, look for a therapist with whom you feel comfortable discussing personal issues. A relational therapist should be a warm, empathetic, understanding, and nonjudgmental person, because the success of relational therapy is highly dependent on the client’s ability to form a personal relationship with the therapist.
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