PTSD, But, Well…. Complex.

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PTSD is typically associated with military veterans, for example, or sexual assault survivors. There was a clear, indisputable, Bad Thing™ that was experienced, and it left a psychological scar. When something happens to remind us of that—say, there are fireworks, or somebody touches us a certain way—it’ll trigger an immediate strong response of some kind.

These days the word “triggered” has been popularly misappropriated to mean any adverse emotional reaction, often to something trivial.

But, not all trauma is so clear. If PTSD refers to the result of that one time you were smashed with a sledgehammer, C-PTSD (Complex PTSD) refers to the result of having been hit with a rolled-up newspaper every few days for fifteen years, say.

This might have been…

  • childhood emotional neglect
  • a parent with a hair-trigger temper
  • bullying at school
  • extended financial hardship as a young adult
  • “just” being told or shown all too often that your best was never good enough
  • the persistent threat (real or imagined) of doom of some kind
  • the often-reinforced idea that you might lose everything at any moment

If you’re reading this list and thinking “that’s just life though”, you might be in the estimated 1 in 5 people with (often undiagnosed) C-PTSD.

How About You? Take The (5mins) Test Here

Now, we at 10almonds are not doctors or therapists and even if we were, we certainly wouldn’t try to diagnose from afar. But, even if there’s only a partial match, sometimes the same advice can help.

So what are the symptoms of C-PTSD?

  • A feeling that nothing is safe; we might suddenly lose what we have gained
  • The body keeps the score… And it shows. We may have trouble relaxing, an aversion to exercise for reasons that don’t really add up, or an aversion to being touched.
  • Trouble sleeping, born of nagging sense that to sleep is to be vulnerable to attack, and/or lazy, and/or negligent of our duties
  • Poor self-image, about our body and/or about ourself as a person.
  • We’re often drawn to highly unavailable people—or we are the highly unavailable person to which our complementary C-PTSD sufferers are attracted.
  • We are prone to feelings of rage. Whether we keep a calm lid on it or lose our temper, we know it’s there. We’re angry at the world and at ourselves.
  • We are not quick to trust—we may go through the motions of showing trust, but we’re already half-expecting that trust to have been misplaced.
  • “Hell is other people” has become such a rule of life that we may tend to cloister ourselves away from company.
  • We may try to order our environment around us as a matter of safety, and be easily perturbed by sudden changes being imposed on us, even if ostensibly quite minor or harmless.
  • In a bid to try to find safety, we may throw ourselves into work—whatever that is for us. It could be literally our job, or passion projects, or our family, or community, and in and of itself that’s great! But the motivation is more of an attempt to distract ourselves from The Horrors™.

“Alright, I scored more of those than I care to admit. What now?”

A lot of the answer lies in first acknowledging to yourself what happened, to make you feel the way you do now. If you, for example, have an abject hatred of Christmas, what were your childhood Christmases like? If you fear losing money that you’ve accumulated, what underpins that fear? It could be something that directly happened to you, but it also could just be repeated messages you received from your parents, for example.

It could even be that you had superficially an idyllic perfect childhood. Health, wealth, security, a loving family… and simply a chemical imbalance in your brain made it a special kind of Hell for you that nobody understood, and perhaps you didn’t either.

Unfortunately, a difficult task now lies ahead: giving love, understanding, compassion, and reassurance to the person for whom you may have the most contempt in the world: yourself.

If you’d like some help with that, here are some resources:

ComplexTrauma.org (a lot of very good free resources, with no need for interaction)

CPTSD Foundation (mostly paid courses and the like)

Some final words about healing…

  • You are in fact amazing,
  • You can do it, and
  • You deserve it.

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    Even well-educated doctors can be outpaced by patients with chronic illnesses. A seasoned Type 1 Diabetic shares indispensable insights in ‘The Blood Sugar Freedom Formula.’

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  • Anti-Inflammatory Khichri & Tadka

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is halfway between a daal and a risotto; it’s delicious and it’s full of protein, fiber, heathy fats, and flavors. And those flavors? Mostly from health-giving phytochemicals of one kind of another.

    You will need

    For the khichri:

    • 1 oz chana dal
    • 1 oz red lentils
    • 1 oz brown lentils
    • 1 oz quinoa
    • 4 oz wholegrain basmati rice
    • 1 tbsp chia seeds
    • 1 tsp ground turmeric
    • ½ tsp MSG or 1 tsp low-sodium salt

    For the tadka:

    • 2 tbsp avocado oil (or other oil suitable for high temperatures—so, not olive oil on this occasion!)
    • ¼ bulb garlic, thinly sliced
    • 1 fresh red chili (adjust per heat preferences)
    • 1 fresh green chili (adjust per heat preferences)
    • 1 tsp cumin seeds
    • 6 curry leaves
    • 12 twists of freshly ground black pepper

    To serve:

    • Optional: flatbreads or poppadoms
    • Optional: lemon wedges or lime wedges
    • Optional: chopped cilantro or parsley

    Method

    (we suggest you read everything at least once before doing anything)

    1) Simmer the khichri ingredients in 5 cups of water, stirring occasionally if necessary, until it has a risotto-like consistency; this will probably take about 30–40 minutes. This time can be greatly reduced by using a pressure cooker, but obviously you won’t be able to check or stir, so do that only if you know what you’re doing cooking those grains and pseudograins in there, and what settings/timings to use for your specific device.

    2) Make the tadka when the khichri is nearly ready, by heating the 2 tbsp of avocado oil in a skillet until very hot but not smoking, Add the rest of the ingredients from the tadka section, and cook until the garlic is nice and golden.

    3) Pour the tadka over the khichri to serve, with any of the optional accompaniments we mentioned.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Invigorating Sabzi Khordan

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    Have you ever looked at the nutritional values and phytochemical properties of herbs, and thought “well that’s all well and good, but we only use a tiny amount”? Sabzi khordan is a herb-centric traditional Levantine sharing platter served most commonly as an appetizer, and it is indeed appetizing! Never again will “start your meal with a green salad to ensure a gentle blood sugar curve” seem like a chore:

    You will need

    • Large bunch of parsley
    • Small bunch of tarragon leaves
    • Small bunch of basil leaves
    • Small bunch of mint
    • Small bunch of sorrel leaves
    • 7 oz block of feta cheese (if vegan, a plant-based substitution is fine in culinary terms, but won’t have the same gut-healthy benefits, as plant-based cheeses are not fermented)
    • 9 oz labneh-stuffed vine leaves in olive oil (if vegan, same deal as the above, except it’s harder to find plant-based substitutes for labneh (strained yogurt cheese), so you might want to use our Plant-Based Healthy Cream Cheese recipe instead and make your own)
    • 2 tbsp za’atar (you can make your own by blending dried hyssop, dried sumac berries, sesame seeds, dried thyme, and salt—but if you haven’t had za’atar before, we recommend first buying some like the one that we linked, so that next time you know what you’re aiming for)
    • 3 tbsp extra virgin olive oil
    • 10 radishes
    • 6 scallions
    • 9 oz walnuts, soaked in water overnight and drained
    • 1 cucumber, cut into batons
    • Warm flatbreads (you can use our Healthy Homemade Flatbreads recipe)

    Method

    (we suggest you read everything at least once before doing anything)

    1) Arrange the feta, labneh, za’atar, and olive oil in separate little serving dishes.

    2) Arrange everything else around them on a platter.

    3) Serve! You may be thinking: did we really need a recipe to tell us “put the things on a plate”? The answer here is that this one today was shared mostly as a matter of inspiration, because when was the last time you thought to serve herbs as the star of the dish? Plus, it’s an excuse to try za’atar, not something so commonly seen outside of the Levant.

    An alternative presentation

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • The Best Form Of Sugar During Exercise

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝What is the best form of sugar for an energy kick during exercise? Both type of sugar eg glicoae fructose dextrose etc and medium, ie drink, gel, solids etc❞

    Great question! Let’s be clear first that we’re going to answer this specifically for the context of during exercise.

    Because, if you’re not actively exercising strenuously right at the time when you’re taking the various things we’re going to be talking about, the results will not be the same.

    For scenarios that are anything less than “I am exercising right now and my muscles (not joints, or anything else) are feeling the burn”, then instead please see this:

    Snacks & Hacks: Eating For Energy (In Ways That Actually Work)

    Because, to answer your question, we’re going to be going 100% against the first piece of advice in that article, which was “Skip the quasi-injectables”, i.e., anything marketed as very quick release. Those things are useful for diabetics to have handy just in case of needing to urgently correct a hypo, but for most people most of the time, they’re not. See also:

    Which Sugars Are Healthier, And Which Are Just The Same?

    However…

    When strenuously exercising in a way that is taxing our muscles, we do not have to worry about the usual problem of messing up our glucose metabolism by overloading our body with sugars faster than it can use it (thus: it has to hurriedly convert glucose and shove it anywhere it’ll fit to put it away, which is very bad for us), because right now, in the exercise scenario we’re describing, the body is already running its fastest metabolism and is grabbing glucose anywhere it can find it.

    Which brings us to our first key: the best type of sugar for this purpose is glucose. Because:

    • glucose: the body can use immediately and easily convert whatever’s spare to glycogen (a polysaccharide of glucose) for storage
    • fructose: the body cannot use immediately and any conversion of fructose to glycogen has to happen in the liver, so if you take too much fructose (without anything to slow it down, such as the fiber in whole fruit), you’re not only not going to get usable energy (the sugar is just going to be there in your bloodstream, circulating, not getting used, because it doesn’t trigger insulin release and insulin is the gatekeeper that allows sugar to be used), but also, it’s going to tax the liver, which if done to excess, is how we get non-alcoholic fatty liver disease.
    • sucrose: is just a disaccharide of glucose and fructose, so it first gets broken down into those, and then its constituent parts get processed as above. Other disaccharides you’ll see mentioned sometimes are maltose and lactose, but again, they’re just an extra step removed from useful metabolism, so to save space, we’ll leave it at that for those today.
    • dextrose: is just glucose, but when the labeller is feeling fancy. It’s technically informational because it specifies what isomer of glucose it is, but basically all glucose found in food is d-glucose, i.e. dextrose. Other isomers of glucose can be synthesized (very expensively) in laboratories or potentially found in obscure places (the universe is vast and weird), but in short: unless someone’s going to extreme lengths to get something else, all glucose we encounter is dextrose, and all (absolutely all) dextrose is glucose.

    We’d like to show scientific papers contesting these head-to-head for empirical proof, but since the above is basic chemistry and physiology, all we could find is papers taking this for granted and stating in their initial premise that sports drinks, gels, bars usually contain glucose as their main sugar, potentially with some fructose and sucrose. Like this one:

    A Comprehensive Study on Sports and Energy Drinks

    As for how to take it, again this is the complete opposite of our usual health advice of “don’t drink your calories”, because in this case, for once…

    (and again, we must emphasize: only while actively doing strenuous exercise that is making specifically your muscles burn, not your joints or anything else; if your joints are burning you need to rest and definitely don’t spike your blood sugars because that will worsen inflammation)

    …just this once, we do want those sugars to be zipping straight into the blood. Which means: liquid is best for this purpose.

    And when we say liquid: gel is the same as a drink, so far as the body is concerned, provided the body in question is adequately hydrated (i.e., you are also drinking water).

    Here are a pair of studies (by the same team, with the same general methodology), testing things head-to-head, with endurance cyclists on 6-hour stationary cycle rides:

    CHO Oxidation from a CHO Gel Compared with a Drink during Exercise

    Meanwhile, liquid beat solid, but only significantly so from the 90-minute mark onwards, and even that significant difference was modest (i.e. it’s clinically significant, it’s a statistically reliable result and improbable as random happenstance, but the actual size of the difference was not huge):

    Oxidation of Solid versus Liquid CHO Sources during Exercise

    We would hypothesize that the reason that liquids only barely outperformed solids for this task is precisely because the solids in question were also designed for the task. When a company makes a fast-release energy bar, they don’t load it with fiber to slow it down. Which differentiates this greatly from, say, getting one’s sugars from whole fruit.

    If the study had compared apples to apple juice, we hypothesize the results would have been very different. But alas, if that study has been done, we couldn’t find it.

    Today has been all about what’s best during exercise, so let’s quickly finish with a note on what’s best before and after:

    Before: What To Eat, Take, And Do Before A Workout

    After: Overdone It? How To Speed Up Recovery After Exercise

    Take care!

    Share This Post

Related Posts

  • The Dark Side Of Memory (And How To Make Your Life Better)
  • Reading As A Cognitive Exercise

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Reading, Better

    It is relatively uncontroversial to say that reading is good for cognitive health, but we don’t like to make claims without science if we can help it, so let’s get started:

    There was a 2021 study, which found that even when controlling for many other factors, including highest level of education, socioeconomic status, and generalized pre-morbid intelligence:

    ❝high reading activity, as defined by almost daily reading, was associated with lower odds of cognitive decline, compared to low reading activity❞

    ~ Dr. Carol Chan

    Source: Can reading increase cognitive reserve?

    However, not all reading is the same. And this isn’t just about complexity or size of vocabulary, either. It’s about engagement.

    And that level of engagement remains the key factor, no matter how quickly or slowly someone reads, as the brain tends to automatically adjust reading speed per complexity, because the brain’s “processing speed” remains the same:

    Read more: Cognitive coupling during reading

    Everyone’s “processing speed” is different (and is associated with generalized intelligence and executive functions), though as a general rule of thumb, the more we practice it, the faster our processing speed gets. So if you balked at the notion of “generalized intelligence” being a factor, be reassured that this association goes both ways.

    Read more: The unique contribution of working memory, inhibition, cognitive flexibility, and intelligence to reading comprehension and reading speed

    So is the key to just read more?

    That’s a great first step! But…

    The key factor still remains: engagement.

    So what does that mean?

    It is not just the text that engages you. You must also engage the text!

    This is akin to the difference between learning to drive by watching someone else do it, and learning by getting behind the wheel and having a go.

    When it comes to reading, it should not be a purely passive thing. Sure, if you are reading a fiction book at bedtime, get lost in it, by all means. But when it comes to non-fiction reading, engage with it actively!

    For example, I (your writer here, hi), when reading non-fiction:

    • Read at what is generally considered an unusually fast pace, but
    • Write so many notes in the margins of physical books, and
    • Write so many notes using the “Notes” function on my Kindle

    And this isn’t just like a studious student taking notes. Half the time I am…

    • objecting to content (disagreeing with the author), or
    • at least questioning it, or which is especially important, or
    • noting down questions that came to my mind as a result of what I am reading.

    This latter is a bit like:

    • when you are reading 10almonds, sometimes you will follow our links and go off down a research rabbit-hole of your own, and that’s great!
    • sometimes you will disagree with something and write to tell us, and that’s great too (when this happens, one or the other or all of us will learn something, and yes, we have published corrections before now)!
    • sometimes what you read here will prompt a further question, and you’ll send that to us, and guess what, also great! We love questions.

    Now, if your enjoyment of 10almonds is entirely passive, don’t let us stop you (we know our readers like quick-and-easy knowledge, and that’s good too), it’s just, the more you actively engage with it, the more you’ll get out of it.

    This, by the way, was also a lifelong habit of Leonardo da Vinci, which you can read about here:

    How to Think Like Leonardo da Vinci: Seven Steps to Genius Every Day – by Michael J. Gelb

    a very good book that we reviewed last year

    How you read (i.e. what medium) matters too!

    Are you reading this on a desktop/laptop, or a mobile device? That difference could matter more than the difference between paper and digital, according to this study from 2020 that found…

    ❝The cumulation of evidence from this and previous studies suggests that reading on a tablet affords different interactions between the reader and the text than reading on a computer screen.

    Reading on a tablet might be more similar to reading on paper, and this may impact the attentional processes during reading❞

    ~ Dr. Ugo Ballenghein et al.

    Read more: Cognitive engagement during reading on digital tablet: Evidence from concurrent recordings of postural and eye movements

    What if my mind wanders easily?

    You can either go with it, or train to improve focus.

    Going with it: just make sure you have more engaging reading to get distracted by. It’s all good.

    Training focus: this is trickier, but worthwhile, as executive function (you will remember from earlier) was an important factor too, and training focus is training executive function.

    As for one way to do that…

    Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering

    If you’d like a primer for getting going with that, then you may enjoy our previous main feature:

    No-Frills, Evidence-Based Mindfulness

    Enjoy!

    Don’t Forget…

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  • Who will look after us in our final years? A pay rise alone won’t solve aged-care workforce shortages

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Aged-care workers will receive a significant pay increase after the Fair Work Commission ruled they deserved substantial wage rises of up to 28%. The federal government has committed to the increases, but is yet to announce when they will start.

    But while wage rises for aged-care workers are welcome, this measure alone will not fix all workforce problems in the sector. The number of people over 80 is expected to triple over the next 40 years, driving an increase in the number of aged care workers needed.

    How did we get here?

    The Royal Commission into Aged Care Quality and Safety, which delivered its final report in March 2021, identified a litany of tragic failures in the regulation and delivery of aged care.

    The former Liberal government was dragged reluctantly to accept that a total revamp of the aged-care system was needed. But its weak response left the heavy lifting to the incoming Labor government.

    The current government’s response started well, with a significant injection of funding and a promising regulatory response. But it too has failed to pursue a visionary response to the problems identified by the Royal Commission.

    Action was needed on four fronts:

    • ensuring enough staff to provide care
    • building a functioning regulatory system to encourage good care and weed out bad providers
    • designing and introducing a fair payment system to distribute funds to providers and
    • implementing a financing system to pay for it all and achieve intergenerational equity.

    A government taskforce which proposed a timid response to the fourth challenge – an equitable financing system – was released at the start of last week.

    Consultation closed on a very poorly designed new regulatory regime the week before.

    But the big news came at end of the week when the Fair Work Commission handed down a further determination on what aged-care workers should be paid, confirming and going beyond a previous interim determination.

    What did the Fair Work Commission find?

    Essentially, the commission determined that work in industries with a high proportion of women workers has been traditionally undervalued in wage-setting. This had consequences for both care workers in the aged-care industry (nurses and Certificate III-qualified personal-care workers) and indirect care workers (cleaners, food services assistants).

    Aged-care staff will now get significant pay increases – 18–28% increase for personal care workers employed under the Aged Care Award, inclusive of the increase awarded in the interim decision.

    Older person holding a stabilising bar
    The commission determined aged care work was undervalued.
    Shutterstock/Toa55

    Indirect care workers were awarded a general increase of 3%. Laundry hands, cleaners and food services assistants will receive a further 3.96% on the grounds they “interact with residents significantly more regularly than other indirect care employees”.

    The final increases for registered and enrolled nurses will be determined in the next few months.

    How has the sector responded?

    There has been no push-back from employer groups or conservative politicians. This suggests the uplift is accepted as fair by all concerned.

    The interim increases of up to 15% probably facilitated this acceptance, with the recognition of the community that care workers should be paid more than fast food workers.

    There was no criticism from aged-care providers either. This is probably because they are facing difficulty in recruiting staff at current wage rates. And because government payments to providers reflect the actual cost of aged care, increased payments will automatically flow to providers.

    When the increases will flow has yet to be determined. The government is due to give its recommendations for staging implementation by mid-April.

    Is the workforce problem fixed?

    An increase in wages is necessary, but alone is not sufficient to solve workforce shortages.

    The health- and social-care workforce is predicted to grow faster than any other sector over the next decade. The “care economy” will grow from around 8% to around 15% of GDP over the next 40 years.

    This means a greater proportion of school-leavers will need to be attracted to the aged-care sector. Aged care will also need to attract and retrain workers displaced from industries in decline and attract suitably skilled migrants and refugees with appropriate language skills.

    Nursing students practise their skills
    Aged care will need to attract workers from other sectors.
    nastya_ph/Shutterstock

    The caps on university and college enrolments imposed by the previous government, coupled with weak student demand for places in key professions (such as nursing), has meant workforce shortages will continue for a few more years, despite the allure of increased wages.

    A significant increase in intakes into university and vocational education college courses preparing students for health and social care is still required. Better pay will help to increase student demand, but funding to expand place numbers will ensure there are enough qualified staff for the aged-care system of the future. The Conversation

    Stephen Duckett, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Don’t Forget…

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  • The Seven Principles for Making Marriage Work – by Dr. John Gottman

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    A lot of relationship advice can seem a little wishy-washy. Hardline clinical work, on the other hand, can seem removed from the complex reality of married life. Dr. Gottman, meanwhile, strikes a perfect balance.

    He looks at huge datasets, and he listens to very many couples. He famously isolated four relational factors that predict divorce with 91% accuracy, his “Four Horsemen”:

    1. Criticism
    2. Contempt
    3. Defensiveness
    4. Stonewalling

    He also, as the title of this book promises (and we get a chapter-by-chapter deep-dive on each of them) looks at “Seven principles for making marriage work”. They’re not one-word items, so including them here would take up the rest of our space, and this is a book review not a book summary. However…

    Dr. Gottman’s seven principles are, much like his more famous “four horsemen”, deeply rooted in science, while also firmly grounded in the reality of individual couples. Essentially, by listening to very many couples talk about their relationships, and seeing how things panned out with each of them in the long-term, he was able to see what things kept on coming up each time in the couples that worked out. What did they do differently?

    And, that’s the real meat of the book. Science yes, but lots of real-world case studies and examples, from couples that worked and couples that didn’t.

    In so doing, he provides a roadmap for couples who are serious about making their marriage the best it can be.

    Bottom line: this is a must-have book for couples in general, no matter how good or bad the relationship.

    • For some it’ll be a matter of realising “You know what; this isn’t going to work”
    • For others, it’ll be a matter of “Ah, relief, this is how we can resolve that!”
    • For still yet others, it’ll be a matter of “We’re doing these things right; let’s keep them forefront in our minds and never get complacent!”
    • And for everyone who is in a relationship or thinking of getting into one, it’s a top-tier manual.

    Click here to check out the Seven Principles for Making Marriage Work and secure what’s most important to you!

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    Learn to Age Gracefully

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