a patient story

Life, emotions and Irritable Bowel Syndrome

February 26, 2024 Daniel Baden ND Episode 39
a patient story
Life, emotions and Irritable Bowel Syndrome
Show Notes Transcript

All of us have a history full of happy, sad and embarrassing events. Some more traumatic than others. How we carry the emotions attached to those moments can impact our health and ability to thrive. Dr Michelle Woolhouse, an experienced integrative doctor is passionate about helping her patients understand and appreciate their emotions. Tune in for one of our most enlightening episodes so far where Dr Woolhouse gives her patient the tools and teaches her how to dig for the  roots that hold back her ability to heal.

. Doctor Michelle Woolhouse, how lovely to see you again. Oh, thanks Daniel. So lovely to be invited to speak on your show. Yeah. Thank you so much. You're an integrative GP and in fact a very well known integrative GPI. Know that you've spoken at many conferences around Australia. You have high respect from your peers, but you're also an author and a podcaster yourself. What's the name of your podcast? So I am one of the hosts on the FX Medicine podcast. We just interviewed Adrian Lopresti last week and I know that he's one of your Co hosts. Yeah. My Co host. There's a nice happy coincidence. Michelle. You focus on emotional processing with many of your patients, and I guess it's a journey you've come to over time. I've read your book, so I know that that you've had an interest in the emotional side of human beings for a very long time. You come through medical school, you learn a lot about the body, you learn about a lot about drugs. And how is your journey taking you to this point? Well, I can. I can answer that in so many different ways, but I mean effectively. I did a post grad in mind body medicine way back in 2002 and I was the first graduate in Australia in mind body medicine back in medical school. I loved three different subjects, so I really excelled at psychology, neurology and immunology. And so when I found the Mind Body Medicine course was in fact actually a postgrad in psycho neuroimmunology, I was like, Oh my God, that's my baby. And I think what I've always loved looking at is the interconnections. And I think that's what attracted me so much to natural medicine rather than the more paternalistic kind of quick fix Western medicine is that I just loved looking at underlying causes. I loved looking at I guess the temperament and the personality and the background and the relational skills of people. And after 20 plus years of clinical practice and observing I guess human behaviour relationships and the impact of chronic disease and certainly there's some patients that seem to really be able to kind of take what you tell them and run with it And and they really look kind of like your golden sort of patience. And you can see like wow, just the their integrity, their enthusiasm, their commitment, their curiosity really serves them very well. And of course there's a group of patients that despite seemingly wanting that would often fall on their heads, You know, they would often fall and have this kind of, I guess self deprecating attitude. Whether it was a kind of a shame cycle or or all sorts of other kind of factors that got me really fascinated about the role of early adverse childhood events or the impact of trauma on the individual's journey through their health care. So whether it's a physical health or a mental health condition, and of course, I've had my own journey. So, you know, I grew up in a in a family, like everyone. And there was a lot of I got brought into an anxious type of family with some vicarious trauma and some transgenerational trauma. And not that I knew it at the time and I had a lovely happy childhood or what seemed like that, but there was some imprints that made it very difficult for me to kind of, I guess. Well, not made it difficult for me, but they, they laid the foundation for me, for my personality and my skill sets etcetera, and they made me very sensitive to humanity and and to the world. And so going through medical school, which is not an easy task for anyone, it's highly laborious, it's long hours, it's very competitive, it's almost dehumanised in in many ways and it's well versed that it's such such a difficult journey. I started to develop anxiety and became quite intolerant to stress and got quite overwhelmed and etcetera. And so I had to really learn my own kind of skill set with that. And so, like many of us is, you know, my own personal interpretation plus what I was witnessing plus what I was learning. The emotional impact of illness is just such a profound influencing factor which I don't think is really given enough credence to the importance for most people's chronic illnesses. It's such a fascinating area I'd I'd followed some of the work of some US based psychiatrist who had followed cases of intergenerational trauma. But these particular studies, they looked at Jewish Holocaust survivors and the children and the grandchildren of these Holocaust survivors. And whilst I understand there's a lot of learnt behaviour which it can be very subtle, little things people say here or there or even the way they hold a facial expression can affect how someone thinks or trigger an emotional response in a in a in a child or another human being. But this in these studies they're also looking at physiological adaption. So high levels of cortisol were transferred for no apparent reason or no understood reason I should say from a grandparent to a grandchild and and there was some connection there which we just don't understand. So I I imagine your body of work is involved in all of that, trying to understand the learnt behavioral patterns, even the Super subtle ones and also the physiological responses that we don't always understand but know they're there 'cause we can measure them in blood or other ways and and trying to tile that together. And I guess that's what psychoneuroimmunology is, is all about. And what's the difference to you between psychoneuroimmunology and emotional processing? Or is it the same thing? Well, it's not really. I mean I guess psychoneuroimmunology really is the kind of field of understanding or education that allows the looking in of all those different body processes. And in fact, you know, since psycho neuroimmunology was a term that was coined, along came psycho neuroendocrinology, psycho neurocardiology. And there's now even a area of research of psycho neuro spirituality. And so like about 10 or even more than a decade ago, there was a group in America that created the Connectome Project, which actually looked at the way that not only does the brain interconnect, but how the brain interconnects to the whole of the body. And they use techniques which I'm I'm not a physicist, so don't fully. I'm not fully across but and essentially this understanding of connection within our own state, within our own Physiology but also interrelationally so how our nervous systems interrelate or Co regulate with the planet as far as like trees and the environment and other people and animals and beyond. So having kind of such a curious combined in that kind of way like I just loved and was so fascinated with this interconnection piece. And so that is really the science kind of of psycho neuroimmunology. And what it did was that it allowed me a foundation to explain people the science and the importance of connection. And that can be from connecting the digestive system to the brain. It can be connecting the the essence and the spirituality of food to the essence and spirituality of a human being. You know like alive foods are going to impact to human being much more positively than dead foods. You know and we all know, I know your your audience is well versed on probably the level of dead foods that we've got in our in our community as well. And so that was really the foundation to and and so exciting for me to actually recognize that there was a science behind you know, long term stress, chronic stress on immunity, on inflammation, on hormonal dysregulation etcetera. And so that almost, I guess was a foundation for people to understand that it wasn't just a hormone dysregulation. Although people come to me all the time and they say I need to fix my hormones. And it's like, well, hormones are the messenger. So it's a little bit like shooting the postman. If you get a bad package, it's like, well, you go to look at who sent the package in the 1st place or understand why the package was kind of sent to you, not the, it's not the Postman's fault, they're just the messenger. And so that's really important information for people to recognize because then despite it sometimes feeling like a little bit more complicated in terms of their autonomy, it's actually in fact very empowering to understand what sits behind your own Physiology and that there is autonomy in every choice and every condition that you do have. So that's essentially what Psychoneuroimmunology. So emotional processing for me is a little bit different. It's probably one of the tools that I would use in which to understand emotions in a different kind of realm. So the way that I teach people to understand emotions is that emotions are information that come from the body. So it's like emotions of the language of the body. And what happens is that we live in a culture that tends to be dismissive of some emotions and really amplify other emotions. So we have this kind of veneer of positive positivity. And so whenever we feel angry or fearful or grief stricken or guilt ridden, we'll tend to see them as a negative impact and some people will push them away or repress them or won't feel comfortable to express them. And so we also in children, for example, if a little kid is angry, they might have been shamed for their anger or they might have been shut down for their anger. And so when they feel angry as an adult, that's that sort of sense of like I'm going to be shut down or I'm going to be ostracized. So they they tend to kind of repress that emotion, whereas once we see emotions as information, they become like a a navigational map in which to understand the truest kind of impact of things. So I'll give you an example for me. So I have some because I've done a lot of emotional understanding. I have some key emotions that tend to be my go to. So one is envy. I feel very fortunate and I'm I feel like I have a good handle on things. But when I do get myself stressed or in overwhelm or I'm overburdened, I start to envy other people or envy other things. And so for me that becomes information of like ah, you're doing too much. You don't have this spaciousness in your life. Your balance is out. And so rather than saying like why are you such an envious person, what are you doing envying that you shouldn't, envying that like you don't need anything more or whatever. I might separate myself. I I just take it as a as a source of wisdom and a message from inside of myself and go, I'm doing too much. I'm out of balance and so if I could then go back into balance then the envy starts to to drop away and that's what I would call emotional processing. So turning emotions into information. It's funny. You choose envy because perceptions are also everything. And from knowing about you and and meeting you a few times, I look at you and go, wow, she's a woman that's got herself together. She's really got everything. And then for you to say envy is a trick, I'm going oh, really? Yes, I know you never know about each other and it's really nice isn't it, to kind of reveal that size because perception is everything. Like probably people you know do look at somebody like me that has I've, I've been very fortunate to have lots of life successes and but you know like I've also been very lucky in many ways too And the perception that you've got it easy or or whatever, which I do in many ways, but also my emotional landscape is also my emotional landscape. It's very hidden from everybody else. And so it's nice to kind of share these things with people because it it humanizes, it humanizes us all. And I think the other beautiful thing about emotional processing is the understanding not only of the language of your own body, but also that everybody shares these emotions. And so shame is a really important emotion that really lingers when we don't share it. So it's a secret emotion. And when we feel ashamed of maybe something we've done, something we've said, even the thoughts that we're having often we'll never reveal that to another person. And Carl Jung talks about shame as almost being a kind of basis of so much human suffering. And a couple of years ago, and it came out of the research of the prisoner of war camps in in China, that they came up with 9 innate emotions. And shame is one of them. And the positive aspect of shame is that it helps to control a group of people when they need to be controlled instantaneously. So it's an instantaneous shutdown. So let's say, for example, as we evolved, we were like you and me, we were teenagers and we were sort of part of the chimpanzees, 500 chimpanzees kind of mucking around in the trees. And all of a sudden this threat appeared. There's a couple of wayward teenagers in the chimpanzees and stuff. The the elders of that group, if they needed to get those people who were doing the wrong behaviour to behave, they would shame them and instantly bring them back into the group for the purpose of survival. And when I learnt that I was like, Oh my God, that is so, so curious. Because what it allowed me for my own shame was to actually know that everybody had it, and so that I could share it knowing that when I did share it, other people would actually have an appreciation. And so the beautiful thing about emotional processing in terms of shame is once we share something that we felt ashamed of, it instantly loses a lot of power over us. And it can be tremendous healing for people that carry around a lot of shame. And I guess a lot of societal orientation is is encouraging shame in some ways. And that might come through religion or other groups that people belong to, you know? But even even our education systems, you know, like we've got people that excel academically get the awards and those that be really great dancers or that you can't, the school may not offer that they don't get any awards at the school assembly, whereas the person that's, you know, really good at specialist maths. You know you mentioned a couple of things one of them was that you feel lucky and and we that's another whole podcast Michelle because I I actually think we create our own luck and there's a lot of perception there as well but and I think you've worked hard there was a famous golfer that once said funny people tell me I'm lucky but the harder I work the luckier I get. But I feel ultimately that many people have a an innate connection with nature, with good food. But I think through circumstance they're often forced to forget it or dismiss it or suppress it. And I guess that's causes a number of the problems that that we see clinically every day. But yeah, sorry, go on. I was just going to say like, I think what's happened since. I mean, obviously I was a, you know, a high achiever at school and worked and did work really hard and medicine was gruelling and. But the one thing that medicine teaches you to do, and I'm sure a lot of your listeners would agree, is just keep working and working and working. You know, like, I remember the first day that I was an intern. I didn't, I didn't go to the toilet all day.

I did my first way at 5:

00 PM and it was really dark, you know, like there was no water drunk. There was no toilet stops. There was nothing. It was just run, run, run. And what neuroplasticity tells us is that, you know, we can adapt to stressors and get really good at dealing with stress, but that doesn't necessarily mean that it's good for us. And one of the things that I've been playing around with his creativity over the last couple of years, because creativity is is kind of almost like the heart in many ways. It it only comes when there's spaciousness. So when we kind of do the sort of linear reductionist type sort of job going on and on and on doing things and working, working, working and accumulating or being productive, often we lack creativity that comes when we're still or when we're with nature and so we can get kind of addicted to the productivity. And often it's the times where we just go off, do nothing that the best ideas kind of arrive. I I couldn't agree more. And there's recently been some media around in in the science literature around the loss of creativity in humans overall because of the connection to the Internet and social media. So people just can't deal with blanks in their life. They just have to keep fiddling with their phone and and and that just kills creativity for a lot of people and I think it's a terrible shame personally. There's not enough with social media. There's not enough time to process. Like, you know, even when you read a poem on social media, which is beautiful, you kind of flick onto the next. So you sort of read the poem but infuse into your sort of daily life, so. You don't get time to consider each word. That's right. Everything you do, we'd like to draw a a full stop at the end of it. And so we're going to be discussing a case where your work can be seen. And today we'll be talking about a lady whose age I don't know, but she lost her pregnancy and I don't know if it was early or late term and but I'm sure you'll fill in the blanks. So could you start talking about your case? So this particular patient of mine is in her 30s and the pregnancy that she lost was late term. And when you lose a late term pregnancy, obvious. Obviously you have to go through the labour process, which is thought to be better psychologically to help somebody navigate that grief and loss from a late term till birth. But all the same, it's a very traumatic experience for the family, for a woman and for for all of those involved. And so that was a very traumatic event for her. But she went on to have a couple of other healthy children, so she did get pregnant naturally. It was, it was one of those events. And she came to see me because for looking for support for IBS and you know, she was bloating and had some irregular bowel habits, and she'd done quite a lot of things before in the past she'd seen. Other complementary medicine therapists, she'd had gastroscopes and colonoscopes, and so we knew we were dealing with a functional such physiological issue. Here. I knew I didn't need to kind of look and see whether there was any underlying causes for what was kind of going on. But what immediately struck me when I met her was the level of tension in her body and just even from the prosody of her voice, the speed of of the way that she presented herself and also her muscle tone, you know, just the way she held her body. And so despite her, you know, looking for support in that, what sort of diet do I what? What should I be eating? What sort of foods would I be looking at for IBS support? I chose instead to go down the kind of nervous system pathway to teach her to reflect and find out a little bit more about the level of nervous tension and sympathetic nervous system OverDrive that was going on in her life. Was she ready for that part of the journey? Was she ready that she came in with an expectation of a new diet or a new supplement or a new probiotic and wanted a quick fix, quick prescription? Was she ready for the journey you were taking her on? Yeah, it's really interesting. I mean it's such a good question and I've asked myself, I actually asked myself that after I saw her. And I guess what I do is I see my role as providing, I guess the expertise of what what occurs, you know, when you when you are a clinician of of 25 years and everybody's kind of looking for underlying causes for all of those different things. When I asked her a couple of things about her diet and her lifestyle, what I did notice is that she was doing a lot of exercise and in fact you could probably argue that she was over exercising and that she was very strict with her diet anyway. So her diet was incredibly clean. I mean, I wasn't talking about a standard Australian diet with wheat beaks and ham cheese, toasty, etcetera, kind of, you know, meal. It was very much a very clean kind of diet anyway. And so that kind of gives me a little bit of a cue to say, like, where am I going to go if if not, to further reduce and further make tension in this person's life already. She was already exercising quite excessively and her diet was very, very strict and very clean. And so I was getting very much this impression of this very lots and lots of tension and lots of rigidity in her life, for which I asked her a lot about it. When I asked her just some roundabout kind of questions with that, I noticed that when she would give me the answers, she very much minimized her experience of life. As in like, well, I'm very fortunate, you know, when she told me about the loss of her baby was like, but I've got two very healthy kids, you know, when I asked her about her relationship, Yes. My husband works very hard. He's a very good, like, we're very good. We're very good.

Hazma might leave at 6:00 in the morning and get home at 8:

00 PM at night. So, you know, that's a long period of time to be the sole carer and he often has times away and then the time she's sort of fitting it in. So the picture started to kind of evolve for me that there was a lot of minimization of her stressors and that she can consider herself incredibly lucky. Yet I was feeling just an enormous level of stress. So back to your question, was she ready? That was only found out in Forsyth. So what happened was that I introduced some of the concepts of stress to her and I said to her, I wonder whether stress is playing a significant role with how your digestive system is working. And I I guess I educated her about sometimes that we can get stuck. So the nervous system and the way that the information gets sent into the brain can go on automatic pilot. Just like we can normalise, say like high work levels or work stress or chronic kind of stress, we can get chronic feedback from the stuff like our digestive system. So it's a little bit like chronic pain. So for anyone that understands chronic pain can be trapped, even though the original injury is actually healed, the pain messages can keep firing in the brain. And that's kind of what happens with irritable bowel syndrome as well. We can have chronic messages of bloating or hyperextension or distension in the gut that's actually just chronically triggered to the brain. So she was curious about those kind of insights as well, that she might have had this pattern that was stuck. So what I ended up doing was I I've said to her, I really would love to just explore this whole theory of mine around the impact of stress and whether that's playing a role, because whether it's playing the entire role, it's likely to be playing a significant role. And so that was giving her information that she could feel empowered about rather than disempowered, and that we could look at one avenue of healing that she'd never looked at before. And and I also emphasized that I thought her diet was excellent and that that was something that she should be congratulated about. And so we went and we did some saliva cortisol tests on her and her results came back off the scale. I have never, never ever, ever has Have I seen higher cortisol results? In fact, actually no. There was one other time, but both. But both of the people that I'm referring to with this extraordinarily high levels of stress had no idea that they're under it. Could you just briefly explain what cortisol is in its relationship to humans and stress? Yeah. So cortisol is one of the main hormones that secreted in both acute and chronic stress. So it's one of the signals that when a person is under stress or an attack or there's a predator or a natural disaster for example, then the body will get that information and ramp up via chemicals such as adrenaline and cortisol, the inflammatory and stress response. So cortisol is slightly slower impact than adrenaline, but what it does primes the body for attack. So it increases our inflammation, it increases our clotting factors, it changes the way our blood flows. So blood will then flow into the heart and the lungs and the eyes and the muscles and away from the digestive system, the reproductive system and other organs that are not necessarily acutely required at that time and over chronic stress. So for example, couple of thousand years ago on the Savannah for example, our biggest threats were obviously predators, natural disasters, weather, etcetera. But nowadays our stresses are a lot more chronic. So we could have excessive workload. We could have, you know, poor sleep. We could have excessive alcohol, relational stressors, financial stressors, etcetera. And so those stresses tend to be much more chronic. So what that leads to is cortisol dysregulation. And so you can often have more elevated levels of cortisol, but what you find over a long period of time and particularly with age is sometimes those cortisol levels will actually drop and fall. So the overarching kind of experience is actually of cortisol dysregulation and it's important thing to to see and to witnessing or can be, but particularly added to the story of what's going on for that person. And it was quite profound for her to see that her body was responding to stress, even though she was kind of denying it and minimizing it in herself. Opening up a conversation about somebody's emotional status and and with the potential of delving deep into a history or a long psychology for some people would put the fear of God into them. And how do you deal with that fear of God and and not drive up their cortisol levels more often? Because some people just don't want to go there. They're really scared about talking about past events, history, family history or something that's happened to them in their lives. Yeah. It's a great question and I think it's really it. It really is how you kind of deliver that in many ways. I think when somebody is having a condition that is very chronic and they've come to you wanting to see whether they can alleviate that chronic condition or even reverse it in some regards, then the emotional quality of that person is really important. Rather than being kind of like this sort of sense of delving in and introspection etcetera. You can frame it a little bit differently as a way of curiosity and finding and exploring answers. And it doesn't have to be this cathartic stand up in front of 20 people. Lie on the couch. Lie. On the couch, there's a lot of myth and rhetoric about emotions that are almost it's damaging. But when you present them as information and really allow your person, like a patient, to learn about and encourage them to develop a more healthy relationship to themselves, it can be a profound Ave. for self empowerment rather than disempowerment. Because I think when people are fearful of delving into their emotions, they feel like their emotions are overwhelming and that there's nothing that they can do about them. So the trick there would be is to actually talk about the empowering factors and what they can do about them and why. Why bother doing that is also really important too. There's a lot of research that actually matches this. So it came out of the study, the ACES study back in the late 80s, early 90s that found that. And it was really a study that came about almost by accident. And there was a a physician in California who was looking into weight loss and found that a lot of people were losing weight. But in fact there was quite a large majority of people that despite losing significant amounts of weight would put it back on again. And so he wanted to find out why this was the case. And asking one particular woman, he really found out these answers that he was not expecting in the sense that she found there was a lot of safety in her weight and that she felt protected by the weight. And based on her trauma that it was actually a protective factor. Which he thought was incredibly fascinating and managed to get some funding and just wanted to do a broad survey of people. And they ended up getting 10,000 people that they looked at adverse childhood events in the society. So there was neglect, there was abuse, and then there was adverse events like poverty or incarceration or war, those kind of things. And of those 10,000 people, they found 67% of people had some form of significant adverse childhood event within their upbringing. And of those people, there was a much higher chance of them getting a chronic disease, not only mentally but physically as well. So the risk to things like type 2 diabetes, lower back pain, even motor vehicle accidents was much higher in those that had the higher ACE score. And so the higher your score, the increase of your risk. I remember reading some material some time ago about who gets IBS Irritable Bowel syndrome, and the highest category was females and females that had suffered some sort of abuse. Physical, psychological, you know, emotional abuse as a child and ties in exactly to what you're talking about. And I I don't know why I was more female, as maybe men would refuse to accept saying what's happening to them, but you know. I think a lot of men have IBS, but they actually just got normal. So that's the toilet story and stuff like that. But. I'm not going to the doctor. I don't care. Exactly. Who cares? What's wrong with sort of, you know, diarrhea every day? Yeah. But I think I think also just on that, that rhetoric of like back before, we actually really did understand the impact of trauma, but also what's happened over the last decade, particularly since we've really got a greater physiological understanding of the impact of trauma which came out of the research from the Vietnam vets for post traumatic stress disorder, we can frame it a whole lot differently. So before it was like, well, what are you going to do? You're just going to bring up my trauma and re traumatize me. And there was a lot of that sort of stuff happening probably in the 70s and the 80s. But from my viewpoint, what's happened over the last decade is there's so much more language and understanding that is occurring. And we're also developing some techniques which can really help to restabilize and heal the nervous system in quite a fascinating and very successful way. And so that is one of the other things to demystify for people is it's not, you don't have to sit on a couch for 10 years, you know, and pen and spend hundreds of thousands of dollars getting therapy. It's a much, yeah. There's a lot of research. More psychological slash counselling type techniques? Or are you including drugs and or supplements or herbal medicines as part of those techniques? Yeah, it's such a good question. I think. I think both work really beautifully like what what the natural medicine world offers this realm of psycho neuroimmunology is support of the nervous system. And what I love about herbal medicine, for example, is that when you look at take withania versus ginseng, Korean ginseng and American ginseng and Japanese ginseng and Russian ginseng, and withania is kind of called the Indian ginseng. Every continent across the globe have herbs that help to settle and adapt the nervous system from processes of stress. Or if you want to use the word trauma but from stress. And so the utilization of of certain nutrients and herbs that support the nervous system can be used really beautifully when the nervous system is up regulated and hypersensitive. For example, sleep is often not as as refreshing or for as long. So using herbs such as lavender or Melissa balm or magnesium thinning etcetera can be so good to make sure that the person's sleep is restorative. It's often when we do emotional processing in the early hours of the morning.

So we want to make sure that that early time between sort of four and 6:00 and 7:

00 in the morning's deep sleep and that's that can be very helpful to allow a person to tack away their emotions and make sure that they're placed into long term memories and re sorted and re reject. And so using the combination of using natural medicine can be really beautiful. Obviously you know St. John's wort's one of my favorite medications, it's an Adaptogen. It really helps to remodel, it's got activities within neuroplasticity and the brain helps stimulate brain derived neurotrophic factor. These are kind of really important factors that we can use from nature to support somebody that has been under a chronic stress or and get the best of both worlds. And obviously coming back to diet for example, we're talking about my patient who did have an exceptionally healthy diet. But if I was working with someone that didn't, modifying alcohol, caffeine, sugar, etcetera and really ramping up good levels of macro nutrients and micronutrients in a person's diet, it's going to have a very important impact on their brain and their nervous system's health. And I think that that it, it's that combination. Likewise with exercise, like exercise is profoundly healing. You know, get it particularly when it's done in nature. I mean you're obviously going to get vitamin D if you have got some sunshine around, but also that increases brain Dr. neurotrophic factor as well. So we're getting brain development, we're getting time to get spaciousness so the emotions can be processed effectively. It's fantastic for releasing of cortisol if it's excessive. So all of those different factors like it, it's not all just talk therapy. Sometimes being nature can allow us to be more connected to something greater than ourselves, and that can be enough to sort of help us to process and to to have a new relationship to whatever we need to reframe. Spending time in nature is just getting so much air at the moment and and we all innately feel that's where we should be. We just don't spend enough time there. But it's associated with all sorts of immune complaints, all sorts of allergies, all sorts of moods, mental health. It's just extraordinary so. Yeah, so forest bathing is is so profound. And when I was doing some research for my book, I had a look into Japanese forest bathing and discovered that trees in fact secrete GABA. So GABA is what we often call our natural Valium. And so when we go into a forest, the trees are secreting Gabba, we pick up on Gabba, we might be, you know we might be making Gabba. I mean just the symbiotic relationship that we have with the natural world is so underrated. And I mean I was thinking actually yesterday I was thinking I am going to do you know like an extended walk, a sort of 10 day walk in nature every year for the rest of. My life. Because there's nothing more profound and awe inspiring than to be off grid in nature. It just does. Magical. Magical. Magical. Things I think you've It sounds like you've been eavesdropping on my wife's conversation, yes? Unreal. Let's do it. Let's do it. Yeah, absolutely. And you run some retreats as well, but we'll talk about those shortly. For a lot of people and and patients that I've had in the past as well, there's stress. And their anxiety around their emotional state is is just part of who they are and how they see their place in the world. And sometimes it's a tough egg to crack because this is who I am, this is how I live, this is how people see me. And so you've got some serious barriers to get through with some patients, I guess. Yeah, absolutely. And look, you know, you've got to meet, you've got to meet a patient where they're at. They're not ready to engage in that. They're not ready to engage. And that's that's completely fine, I think too. I mean, people do get some advantages from staying the same. A lot of relationships are built on kind of repetitive behaviour and and you know that's that's fine as well. How you interact with your relationship with your family of origin, there's patterns that kind of evolve that can be very healing as well and health giving you know a sense of security as well. So for those that are looking for something different, that the illnesses are really impacting, even that they might have to look a little bit differently at the way that the emotional landscape may be impacting them. And again, it can be empowering, but I get it. That's not necessarily for everyone. And sometimes I think there's a saying and I might get this, I might get this wrong. But it's like change happens when the pain of staying the same is worse than the pain of changing. I. Think that that's really important because sometimes we stay the same and we can kind of tolerate the issues that we've got from that. But when those issues become so bad that it almost forces a transformation on us and that's when this kind of style of sort of, I guess therapy can be really helpful. Yeah, they're just bringing it back to your patient again. You saw her. You opened some doors for her to discuss or delve a little bit more into herself. What was the next two or three visits like? Well, I mean it was really interesting because I think it was around Christmas and she needed to cancel. So, So I saw her with those results and we did some nutritional therapy and she was really blown away. And I just asked her to be reflective and just to watch and and also to watch that minimisation in herself. So she had this real pattern that she wasn't, you know, everybody else's problems were much, much more important than her own. And I just asked her to elevate her own needs a little bit in the rank of her life, which she, she said that she would. And she ended up cancelling the next appointment. And then because it was near Christmas, she couldn't get back in because, you know, you know what it's like when you get a little bit crammed. And so I didn't see her for a little while. And I was she, she was in the back of my mind like, you know, lots of my patients have a little. I must have a waiting room in the back of my mind. So isn't that scary? So I've got a little waiting room. She was in my waiting room in the back of my mind and I was really curious and of course I had self doubt and I was thinking, oh, maybe I did push her too far, etcetera. Anyway, she came back to see me and she was way better And I said, oh, you're way better. What have you done? And she said, oh, I think you might get mad at me. And I said keep me with it. And she said I went to see a shaman. I said, oh, OK. She said exactly what you did. I said, oh, OK, that was really, I mean, I think that's really confirmatory, which for me is the power of that community of medicine. Sometimes we get these messages from one person and then, you know, another practitioner will come in and say the same thing. And then it starts to kind of land for that particular person. And I think that there was and appreciation of how much grief she was holding and she was able to start to really recognize the impact of that. But doing that and learning to let that go with compassion was a bit of a game changer for her. And then I think that that allowed a little bit of spaciousness and a little bit more connection with her worthiness and that it mattered. It was, it was big. It was traumatic for her. It didn't matter that she got other kids, she still really needed to process that and that that opened up a communication to a deeper part of herself, which was incredibly transformative. We also did some breathing techniques, really simple breathing techniques to allow her to just develop awareness and and improve that sense of safety inside herself. So she'll get to know her own body, her nervous system, where it was at, rather than being on OverDrive and always kind of subjugating herself to the needs of others. And she was much better. So interesting. I interviewed people of this podcast has been going for about a year, and I've interviewed a lot of people and a lot of females, and there's particularly a notable syndrome amongst mothers who just don't give themselves enough time and don't seem to have enough empathy for themselves or permission for themselves and it. Seems to. Come out in different ways. Yeah, and to be honest, I don't think we look after mothers very well. Yeah, I agree. No, like back in. I mean when I look into sort of evolutionary medicine and stuff, we used to you know, save the most nutritious foods for those that are who are of child rearing age or those that have just, you know, partnered up with someone, you know, we would Revere the mother and and wrap them. You know, now we, we've medicalized pregnancy, we have medicalized birth. We have put a lot of pressure on there's we've also educated women and then taken their careers away from them. We got older mums who often have, you know, aging parents as well and slightly older Physiology to go into motherhood. There is just so, so much pressure and that we don't look after mothers well. I mean, we know the statistics. When a woman becomes a mother, she increases her domestic load instantly just goes up. You know, we have the gender pay gap. We have lack of career choices after pregnancy. It's just extraordinary, the impact of motherhood on a woman's livelihood, on their sense of purpose. And it's really given a lot of lip service, you know in my opinion is in like Oh well at least you know it's it's beautiful, you're a mother, etcetera, which is not to to diminish that, but at the same time the the issues of of early motherhood is definitely minimized I think. I used to do some work in parts of Asia and I remember being at a dinner in Singapore. I think it was with a lady who was about to give birth and she was running a big company and we said we're sitting around table and she said, well, I'm, I'm going to disappear now for three months or six months. She was of Chinese background. And I said, oh, you know what's going on? She said, oh, well, I'm about to give birth and and that's it. My auntie's come in, my mother comes in. I I'm not allowed to do anything. I have to sit in the house, go for a walk if I want to. I'll have the baby. They'll bring me food and they'll make me food every day. And my whole job is to be nourished and to nourish my child. And and that was such a learning experience for me because the Chinese culture for, you know, thousands of years, that's what they've done. They've nourished and welcomed the mother and the baby. And it really is a beautiful, a beautiful way forward. Yeah, absolutely. I think we need to really do that a lot more. And I mean, I know from your natural medicine backgrounds we'll often arrive at somebody's house with you know, six muffins or something. Obviously should be arriving with you know fermented kanji or something for nourishment instead. But aspects of things that can be so supportive, I'm. Sure. You didn't mean to include organic blueberry muffins from the markets up the road here that that'd be, that'd be right? Wouldn't. You. Yeah. Well, yeah, I mean. And are you still in touch with your patient? Yes, yes, a couple of weeks ago. And yeah, she continues to do well. I think the new understanding and the impact of that for her has given opened up a whole new Ave. of potentiality for her and ease. She kind of. Just learnt to give herself a bit of a break as she starts to get better at that. What I was saying before is that learning those emotions and learning to trust what emotions are coming creates A navigational tool for well-being that I think is underrated. What a great outcome. And I'm sure she's not the only one who's benefited from that sort of approach. Michelle, you've written a book called The Wonder Within that. Here's one I prepared earlier. I read this a long time ago, but there was, I remember a couple of things standing out for me, which I really enjoyed. And one of them was, I thought you inserted a lot of yourself into that book. Your personality, your experiences, your life, and I actually love that because I think it brings authenticity to the author, which just makes it a much more identifiable read when you do things like that. So that was great. I really loved the little exercise points that you put in there, the little questions and discussions and a break between chapters to really help the reader digest what you were just talking about and think it through. And I just found that so important. And then for all the Type A personalities out there, you also throw in key points at the end of each chapter. So a quick ready reckoner come back to this. Bullet points love bullet points. Yeah, totally at the end of the chapter. And so look, thank you for that. And is the book still available? I take it, I mean, I bought this copy a long time ago. Where where do you buy it? So you buy it on Amazon, Topia, Unity, Mix, all of the online stores and on my website at www.theholisticgp.com.authe. Holisticgp.com dot AU and. It's also on Audible as well. So if is it Audible, I've actually narrated it myself, which I think because it is such a personal story and what I wanted to do is story, such a powerful way of learning it. I infused it with a lot of storytelling so that people can then take their own frame of reference and and and really get a deeper sort of sense of connection. So yes, it's available with me reading it on Audible. Oh, wonderful. OK. And Michelle, you also run some retreats, don't you? Yeah, we do. So it's called enliven retreats, which is enliven dash retreats.com dot AU. And I was reflecting on this actually. Somebody asked me about it the other day. And I think really what they are about is they're about transformational well-being. And a lot of women come and they're stuck. This kind of understanding of psycho neuroimmunology and their own Physiology and maybe even nervous patterning becomes really entrenched. And so it does take this opportunity to come away, to be with other people in a really beautiful, restful environment, to be able to kind of almost find that spaciousness that allows that new awareness and new learnings to come about. And they're just the most amazing, an amazing opportunity. The next one is called courageously Me, where we look at courage and fear and our relationship to courage and our relationship to fear. So we look at the brain patternings and neuroplasticity, and there's all these other really beautiful creative ways in which we can experience that change and develop new ways of being. And the second one in October, which is the 7th to the 13th, is on wisdom and boundaries. And those kind of key qualities that we all need to sort of learn in which to kind of come back to ourselves and really, really focus on our vision and what we can do. Yeah. Are these retreats typically in Australia or are they? No. So they we, well we're originally going to do them in Australia but we've we've really landed in Urbordin Bali, we've found the most amazing retreat centre and in in many ways because I mean Bali as they call it the land of the gods really houses that sense of spaciousness and almost connection to the land. So I think that that makes a really profound difference and it's always really nice to go away on retreat. There's a process about travelling and that really amplifies the the impact of it. So yeah, they're absolutely beautiful. I run them. My Co facilitator Carolyn Hales. And so we come from our perspectives are very different, but they kind of align in the most, yeah, really quite a magical way. How? Many people would You typically get on or a retreat. Between 14 and 18. Right. OK, good number. That's a really good number. And there's two facilitators, so we can take a few more than if you were on your own. And yeah, we have a lot of fun. It's a lot. Yeah, yeah, you got to have fun. And to finish off this podcast has been a lot of fun and I learned so much. So thank you so, so much for coming on. I know how crazy busy you are, but really appreciate it. And I and I hope all of the listeners got something out of it as well. I'm sure they would have. So thanks Michelle and my pleasure. Thanks to you again I hope. Hope so.